Microneurosurgical anatomy of the basal cisterns: A brief review for cisternostomy

Author:

Villanueva Pablo1,Baldoncini Matías2,Forlizzi Valeria2,Campero Alvaro3,Rangel Carlos Castillo4,Granja Jaime Ordóñez4,Sufianov Albert56,Lucifero Alice Giotta7,Luzzi Sabino78

Affiliation:

1. Department of Neurosurgery, Hospital Gobernador Ernesto Campos, Ushuaia, Tierra del Fuego, Argentina

2. Laboratory of Microsurgical Neuroanatomy, Second Chair of Gross Anatomy, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina

3. Laboratiorio de Innovaciones Neuroquirurgicas de Tucuman (LINT), Facultad de Medicina, Universidad Nacional de Tucumán, Tucumán, Argentina

4. Department of Neurosurgery, “Hospital Regional 1o de Octubre,” Institute of Social Security and Services for State Workers (ISSSTE), Mexico City, Mexico

5. Department of Neurosurgery, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation

6. Chief Physician of the Federal State-Financed Institution “Federal Centre of Neurosurgery” of the Ministry of Health of the Russian Federation, Russian Federation,

7. Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy

8. Neurosurgery Unit, Department of Surgical Sciences, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy

Abstract

Background: Cisternostomy is a surgical technique thought of and developed as an option for severe brain trauma treatment. It demands a particular knowledge and skill to microsurgically approach basal cisterns and effectively manipulate their contents. To perform this procedure safely, the anatomy and pathophysiology must be clearly understood. Methods: Detailed microscopic dissection and anatomical review were done, after a detailed reading of facts and recent publications about cisternostomy. Cisternal pathways and landmark planning are described and augmented using a new method to show de arachnoid borders. Finally, a brief discussion is written as a synopsis. Results: Cisternostomy requires thorough microscopic knowledge and microsurgical skills. This paper intends to provide information to understand better the anatomy related, thus, easing the learning curve. The technique used to show arachnoid borders, complementing cadaveric and surgical images, was useful for this purpose. Conclusion: To perform this procedure safely, it is mandatory to handle microscopic details of cistern anatomy. Reaching a core cistern is necessary to assure effectiveness. This procedure needs, as well, surgical step-by-step landmark planning and performing. Cisternostomy could be a life-saving procedure and a new powerful tool for severe brain trauma treatment. Evidence is being collected to support its indications.

Publisher

Scientific Scholar

Subject

Neurology (clinical),Surgery

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

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