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Villanueva P, Baldoncini M, Forlizzi V, Campero A, Rangel CC, Granja JO, Sufianov A, Lucifero AG, Luzzi S. Microneurosurgical anatomy of the basal cisterns: A brief review for cisternostomy. Surg Neurol Int 2023; 14:97. [PMID: 37025519 PMCID: PMC10070334 DOI: 10.25259/sni_1095_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/14/2023] [Indexed: 04/08/2023] Open
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.
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Affiliation(s)
- Pablo Villanueva
- Department of Neurosurgery, Hospital Gobernador Ernesto Campos, Ushuaia, Tierra del Fuego, Argentina
| | - Matías Baldoncini
- Laboratory of Microsurgical Neuroanatomy, Second Chair of Gross Anatomy, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Valeria Forlizzi
- Laboratory of Microsurgical Neuroanatomy, Second Chair of Gross Anatomy, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Alvaro Campero
- Laboratiorio de Innovaciones Neuroquirurgicas de Tucuman (LINT), Facultad de Medicina, Universidad Nacional de Tucumán, Tucumán, Argentina
| | - Carlos Castillo Rangel
- Department of Neurosurgery, “Hospital Regional 1o de Octubre,” Institute of Social Security and Services for State Workers (ISSSTE), Mexico City, Mexico
| | - Jaime Ordóñez Granja
- Department of Neurosurgery, “Hospital Regional 1o de Octubre,” Institute of Social Security and Services for State Workers (ISSSTE), Mexico City, Mexico
| | - Albert Sufianov
- Department of Neurosurgery, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
- Chief Physician of the Federal State-Financed Institution “Federal Centre of Neurosurgery” of the Ministry of Health of the Russian Federation, Russian Federation
| | - Alice Giotta Lucifero
- Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Sabino Luzzi
- Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Neurosurgery Unit, Department of Surgical Sciences, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy
- Corresponding author: Sabino Luzzi, Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy.
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Wegener S. [Not Available]. PRAXIS 2017; 106:477-481. [PMID: 28443708 DOI: 10.1024/1661-8157/a002661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Zusammenfassung. Unser Gehirn verändert sich mit zunehmendem Alter. Dieser physiologische Prozess kann mithilfe von Magnetresonanztomografie (MRT) beschrieben werden. Im Laufe des Lebens kommt es zu Atrophie (Schrumpfen von Hirnstrukturen) sowie Auftreten von charakteristischen MRT-Signal-Hyperintensitäten in der weissen Substanz. Eine besonders starke oder frühe Ausprägung dieser Veränderungen kann pathologisch sein. Die Abgrenzung zwischen gesundem Altern und Prozessen mit Krankheitswert ist dabei nicht einfach. In diesem Mini-Review sollen normale Alterungsprozesse des Gehirns beschrieben und krankhafte Veränderungen aufgezeigt werden, die weiterer Abklärung und Behandlung bedürfen.
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Bayram E, Akinci G, Topcu Y, Cakmakci H, Giray O, Ercal D, Hiz S. Multi-cystic white matter enlarged Virchow Robin spaces in a 5-year-old boy. Childs Nerv Syst 2012; 28:743-6. [PMID: 22205532 DOI: 10.1007/s00381-011-1663-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 12/13/2011] [Indexed: 10/14/2022]
Affiliation(s)
- Erhan Bayram
- Division of Pediatric Neurology, Department of Pediatrics, Dokuz Eylul University, Izmir, Turkey.
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Nichtweiß M, Weidauer S, Treusch N, Hattingen E. White Matter Lesions and Vascular Cognitive Impairment. Clin Neuroradiol 2012; 22:193-210. [DOI: 10.1007/s00062-012-0134-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 01/17/2012] [Indexed: 12/13/2022]
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