Microsurgical Anatomy And Internal Architecture Of The Brainstem In 3d Images: Surgical Considerations

dc.creatorParraga
dc.creatorRichard Gonzalo; Possatti
dc.creatorLucas Loss; Alves
dc.creatorRaphael Vicente; Ribas
dc.creatorGuilherme Carvalhal; Ture
dc.creatorUgur; de Oliveira
dc.creatorEvandro
dc.date2016
dc.datemaio
dc.date2017-11-13T11:32:49Z
dc.date2017-11-13T11:32:49Z
dc.date.accessioned2018-03-29T05:47:21Z
dc.date.available2018-03-29T05:47:21Z
dc.identifierJournal Of Neurosurgery. Amer Assoc Neurological Surgeons, v. 124, p. 1377 - 1395, 2016.
dc.identifier0022-3085
dc.identifier1933-0693
dc.identifierWOS:000374723000020
dc.identifier10.3171/2015.4.JNS132778
dc.identifierhttp://thejns.org/doi/abs/10.3171/2015.4.JNS132778
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/326140
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1363146
dc.descriptionBrainstem surgery remains a challenge for the neurosurgeon despite recent improvements in neuroimaging, microsurgical techniques, and electrophysiological monitoring. A detailed knowledge of the microsurgical anatomy of the brainstem surface and its internal architecture is mandatory to plan appropriate approaches to the brainstem, to choose the safest point of entry, and to avoid potential surgical complications. METHODS An extensive review of the literature was performed regarding the brainstem surgical approaches, and their correlations with the pertinent anatomy were studied and illustrated through dissection of human brainstems properly fixed with 10% formalin. The specimens were dissected using the fiber dissection technique, under x6 to x40 magnification. 3D stereoscopic photographs were obtained (anaglyphic 3D) for better illustration of this study. RESULTS The main surgical landmarks and their relationship with the cerebellum and vascular structures were identified on the surface of the brainstem. The arrangements of the white matter (ascending and descending pathways as well as the cerebellar peduncles) were demonstrated on each part of the brainstem (midbrain, pons, and medulla oblongata), with emphasis on their relationships with the surface. The gray matter, constituted mainly by nuclei of the cranial nerves, was also studied and illustrated. CONCLUSIONS The objective of this article is to review the microsurgical anatomy and the surgical approaches pertinent to the brainstem, providing a framework of its external and internal architecture to guide the neurosurgeon during its related surgical procedures.
dc.description124
dc.description5
dc.description1377
dc.description1395
dc.languageEnglish
dc.publisherAmer Assoc Neurological Surgeons
dc.publisherRolling Meadows
dc.relationJournal of Neurosurgery
dc.rightsfechado
dc.sourceWOS
dc.subjectBrainstem
dc.subjectFiber Dissection
dc.subjectMicrosurgical Anatomy
dc.subjectSafe Entry Zone
dc.subjectSurgical Approaches
dc.subjectPosterior Fossa
dc.titleMicrosurgical Anatomy And Internal Architecture Of The Brainstem In 3d Images: Surgical Considerations
dc.typeArtículos de revistas


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