Comparison Between Transcortical and Interhemispheric Approaches to the Atrium of Lateral Ventricle Using Combined White Matter Fiber Dissections and Magnetic Resonance Tractography

The objective of this study was to compare transcortical and posterior interhemispheric approaches to the atrium using a combined approach of white matter fiber dissections and magnetic resonance (MR) tractography. Ten cerebral hemispheres were examined and dissected from the lateral-to-medial surfa...

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Bibliographic Details
Published in:World neurosurgery Vol. 138; pp. e478 - e485
Main Authors: Muftah Lahirish, Issa Ali, Middlebrooks, Erik H., Holanda, Vanessa Milanesi, Batista-Quintero, Ruben, Maeda, Fernando Luís, Neto, Mateus Reghin, Parraga, Richard Gonzalo, de Olivieira, Evandro
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01-06-2020
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Summary:The objective of this study was to compare transcortical and posterior interhemispheric approaches to the atrium using a combined approach of white matter fiber dissections and magnetic resonance (MR) tractography. Ten cerebral hemispheres were examined and dissected from the lateral-to-medial surface and from the medial-to-lateral surface, with special attention to the white matter tracts related to the atrium. MR tractography was used to show the relationship of three-dimensional white matter fibers with the atrium of the lateral ventricle and to compare with cadaveric dissection results. The atrium was related laterally to the superior longitudinal fasciculus II and III, middle longitudinal fasciculus, arcuate fasciculus, vertical occipital fasciculus, and sagittal stratum. Medially, it is related to the superior longitudinal fasciculus I, cingulum, sledge runner, and forceps major. A combined approach of cadaveric white matter fiber dissections and MR tractography were used to describe the main white matter tracts related to the posterior interhemispheric approach and the transcortical approach, providing an in-depth understanding of the three-dimensional anatomy of white matter fibers and the atrium. In the present study, among approaches examined, the posterior interhemispheric parasplenial transprecuneus approach placed fewer eloquent tracts at risk; however, traversing the sledge runner and the forceps major is unavoidable by this approach.
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ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2020.02.161