Affiliation:
1. Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India
2. Department of Neurosurgery, Yeditepe University School of Medicine, Istanbul, Turkey
3. Division of Neurosurgery, School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
Abstract
Abstract
BACKGROUND
The cerebellum is one of the most primitive and complex parts of the human brain. The fiber microdissection technique can be extremely useful for neurosurgeons to understand the topographical organization of the cerebellum's important contents, such as the deep cerebellar nuclei and the cerebellar peduncles, and their relationship with the brain stem.
OBJECTIVE
To dissect the deep cerebellar nuclei and the cerebellar peduncles using the fiber microdissection technique.
METHODS
Under the operating microscope, 5 previously frozen, formalin-fixed human cerebellums and brain stems were dissected from the superior surface, and 5 were dissected from the inferior surface. Each stage of the process is described. The primary dissection tools were handmade, thin, wooden spatulas with tips of various sizes, toothpicks, and a fine regulated suction.
RESULTS
In 15 simplified dissection steps (6 for the superior surface and 9 for the inferior surface), the deep cerebellar nuclei (dentate, interpositus, and fastigial) and the cerebellar peduncles (inferior, middle, and superior) are delineated. Their anatomical relationships with each other and other neighboring structures are demonstrated.
CONCLUSION
The anatomy of the deep cerebellar nuclei and the cerebellar peduncles are clearly defined and understood through the use of the fiber microdissection technique. These stepwise dissections will guide the neurosurgeon in acquiring a topographical understanding of these complex and deep structures of the cerebellum. This knowledge, along with radiological information, can help in planning the most appropriate surgical strategy for various lesions of the cerebellum.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Clinical Neurology,Surgery
Reference34 articles.
1. Topographic anatomy of the insular region;Türe;J Neurosurg,1999
2. Is there a superior occipitofrontal fasciculus? A microsurgical anatomic study;Türe;Neurosurgery,1997
3. Fiber dissection technique: lateral aspect of the brain;Türe;Neurosurgery,2000
4. Impact of fMRI-guided advanced DTI fiber tracking techniques on their clinical applications in patients with brain tumors;Kleiser;Neuroradiology,2010
5. Disarrangement of fiber tracts and decline of neuronal density correlate in glioma patients-a combined diffusion tensor imaging and H-MR spectroscopy study;Goebell;Am J Neuroradiol,2006
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