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Resection of the quadrangular lobule of the cerebellum to increase exposure of the cerebellomesencephalic fissure: an anatomical study with clinical correlation.
Serrato-Avila, Juan Leonardo; Paz Archila, Juan Alberto; Monroy-Sosa, Alejandro; Alejandro, Sebastian Aníbal; Costa, Marcos Devanir Silva da; Cavalheiro, Sergio; Yagmurlu, Kaan; Lawton, Michael T; Chaddad-Neto, Feres.
Afiliación
  • Serrato-Avila JL; 1Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil.
  • Paz Archila JA; 3Department of Neurosurgery, Hospital General de Tlahuac, ISSSTE, México City, México.
  • Monroy-Sosa A; 3Department of Neurosurgery, Hospital General de Tlahuac, ISSSTE, México City, México.
  • Alejandro SA; 1Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil.
  • Costa MDSD; 2Laboratory of Microneurosurgery Anatomy, Universidade Federal de São Paulo, Brazil.
  • Cavalheiro S; 3Department of Neurosurgery, Hospital General de Tlahuac, ISSSTE, México City, México.
  • Yagmurlu K; 4Center for Research and Innovation in Neurosciences, Higher School of Medicine, National Polytechnic Institute, México City, México.
  • Lawton MT; 1Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil.
  • Chaddad-Neto F; 2Laboratory of Microneurosurgery Anatomy, Universidade Federal de São Paulo, Brazil.
J Neurosurg ; 140(4): 1160-1168, 2024 Apr 01.
Article en En | MEDLINE | ID: mdl-38564813
ABSTRACT

OBJECTIVE:

The lateral aspect of the cerebellomesencephalic fissure frequently harbors vascular pathology and is a common surgical corridor used to access the pons tegmentum, as well as the cerebellum and its superior and middle peduncles. The quadrangular lobule of the cerebellum (QLC) represents an obstacle to reach these structures. The authors sought to analyze and compare exposure of the cerebellar interpeduncular region (CIPR) before and after QLC resection and provide a case series to evaluate its clinical applicability.

METHODS:

Forty-two sides of human brainstems were prepared with Klingler's method and dissected. The exposure area before and after resection of the QLC was measured and statistically studied. A case series of 59 patients who underwent QLC resection for the treatment of CIPR lesions was presented and clinical outcomes were evaluated at 1-year follow-up.

RESULTS:

The anteroposterior surgical corridor of the CIPR increased by 10.3 mm after resection of the QLC. The mean exposure areas were 42 mm2 before resection of the QLC and 159.6 mm2 after resection. In this series, ataxia, extrapyramidal syndrome, and akinetic mutism were found after surgery. However, all these cases resolved within 1 year of follow-up. Modified Rankin Scale score improved by 1 grade, on average.

CONCLUSIONS:

QLC resection significantly increased the exposure area, mainly in the anteroposterior axis. This surgical strategy appears to be safe and may help the neurosurgeon when operating on the lateral aspect of the cerebellomesencephalic fissure.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cerebelo / Procedimientos Neuroquirúrgicos Límite: Humans Idioma: En Revista: J Neurosurg Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cerebelo / Procedimientos Neuroquirúrgicos Límite: Humans Idioma: En Revista: J Neurosurg Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos