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Window anatomy for neurosurgical approaches. Laboratory investigation.

Abstract：

OBJECT:Knowledge of the cranium projections of the gyral structures is essential to reduce the surgical complications and to perform minimally invasive interventions in daily neurosurgical practice. Thus, in this study the authors aimed to provide detailed information on cranial projections of the eloquent cortical areas. METHODS:Ten formalin-fixed adult human skulls were obtained. Using sutures and craniometrical points, the crania were divided into 8 windows: superior frontal, inferior frontal, superior parietal, inferior parietal, sphenoidal, temporal, superior occipital, and inferior occipital. The projections of the precentral gyrus, postcentral gyrus, inferior frontal gyrus, superior temporal gyrus, transverse temporal gyri, Heschl gyrus, genu and splenium of the corpus callosum, supramarginal gyrus, angular gyrus, calcarine sulcus, and sylvian fissure to cranial vault were evaluated. RESULTS:Three-fourths of the precentral gyrus and postcentral gyrus were in the superior parietal window. The inferior frontal gyrus extended to the inferior parietal window in 80%. The 3 important parts of this gyrus were located below the superior temporal line in all hemispheres. The orbital and triangular parts were in the inferior frontal window, and the opercular part was in the inferior parietal window. The superior temporal gyrus was usually located in the inferior parietal and temporal windows, whereas the supramarginal gyrus and angular gyrus were usually located in the superior and inferior parietal windows. The farthest anterior point of the Heschl gyrus was usually located in the inferior parietal window. The mean positions of arachnoid granulations were measured as 3.9 +/- 0.39 cm anterior and 7.3 +/- 0.51 cm posterior to the bregma. CONCLUSIONS:Given that recognition of the gyral patterns underlying the craniotomies is not always easy, awareness of the coordinates and projections of certain gyri according to the craniometric points may considerably contribute to surgical interventions.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Kendir S,Acar HI,Comert A,Ozdemir M,Kahilogullari G,Elhan A,Ugur HC

doi

10.3171/2008.10.JNS08159

subject

Has Abstract

pub_date

2009-08-01 00:00:00

pages

365-70

issue

eissn

0022-3085

issn

1933-0693

journal_volume

111

pub_type

杂志文章

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Window anatomy for neurosurgical approaches. Laboratory investigation.