White Matter Topographic Anatomy Applied to Temporal Lobe Surgery
Por:
Flores-Justa, A, Baldoncini, M, Cruz, J, Gonzalez, F, Martinez, O, Gonzalez-Lopez, P and Campero, A
Publicada:
1 dic 2019
Resumen:
BACKGROUND: The temporal lobe is an important and complex anatomic region of the brain. Accurate knowledge of anatomic relationships becomes extremely relevant when deciding surgical strategy, such as epilepsy or oncologic surgery, involving this lobe. To our knowledge, there is no strong literature highlighting the relationship between white matter tracts and craniometric landmarks applied to temporal lobe surgery. We aim to describe the topographic relationship between the craniometric points and white matter tracts of the temporal lobe through dissection of cadaveric specimens and describe the potential preoperative usefulness of diffusion tensor imaging in relation to the anatomic features found during the dissections.
METHODS: Fifteen formalin-fixed whole cadaveric heads were dissected by the Klingler technique in a stepwise manner across the temporal and sphenoid bone windows. The white matter pathways were identified in their different planes and their position was described in relation to craniometric landmarks. Diffusion tensor studies were performed in 2 healthy volunteers to analyze the temporal fasciculi in vivo.
RESULTS: We identified the topographic relationships between craniometric points and relevant association tracts that lie within the cranial corridors (superior and inferior frontal, parietal, occipital, sphenoidal, and temporal). Important landmarks were defined in correspondence to these different fasciculi.
CONCLUSIONS: Through this kind of microsurgical anatomic study, a better understanding of the different anatomic layers of the temporal region might be achieved. This factor is essential in planning adequate surgery and strategies to operate in the temporal lobe, improving surgical results and minimizing functional deficits.
Filiaciones:
Flores-Justa, A:
Univ Clin Hosp Santiago de Compostela, Dept Neurol Surg, Santiago De Compostela, Spain
Univ Buenos Aires, Med Sch, Lab Neuroanat Microsurg LaNeMic, Div Anat 2, Buenos Aires, DF, Argentina
Baldoncini, M:
Univ Buenos Aires, Med Sch, Lab Neuroanat Microsurg LaNeMic, Div Anat 2, Buenos Aires, DF, Argentina
San Fernando Hosp, Dept Neurol Surg, Buenos Aires, DF, Argentina
Cruz, J:
IPN, Fac Med, Higher Sch Med, Anat Acad, Mexico City, DF, Mexico
Univ Nacl Autonoma Mexico, Fac Med, Lic Neurosci, Mexico City, DF, Mexico
Gonzalez, F:
Univ Buenos Aires, Clin Hosp, Neurosurg Div, Epilepsy Surg Sect, Buenos Aires, DF, Argentina
Clin Cuyo, Neurosurg Div, Mendoza, Argentina
Martinez, O:
Univ Buenos Aires, Clin Hosp, Neurol Div, Epilepsy Sect, Buenos Aires, DF, Argentina
:
Hosp Gen Alicante, Dept Neurosurg, Alicante, Spain
Campero, A:
Padilla Hosp, Dept Neurol Surg, San Miguel De Tucuman, Argentina
Open Access
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