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Anatomical landmarks for hemispherotomy and their clinical application
Hung Tzu Wen1, Albert L Rhoton, Raul Marino
1Division of Neurosurgery, Hospital das Clínicas, College of Medicine, University of São Paulo, Brazil. wenht@uol.com.br
Journal of Neurosurgery
|November 16, 2004
Summary
This study defines the central core of the hemisphere and proposes anatomical landmarks for hemispherotomy. These landmarks aid in disconnecting the hemisphere from its lateral surface during surgical procedures.
Area of Science:
- Neurosurgery
- Neuroanatomy
Background:
- Hemispherotomy techniques involve disconnecting anatomical structures from the hemisphere's central core.
- Current methods often overlook precise anatomical landmarks for this disconnection.
Purpose of the Study:
- To introduce the surgical concept of the hemisphere's central core.
- To propose key anatomical landmarks for performing hemispherotomies with improved precision.
Main Methods:
- Anatomical study on five adult cadaveric heads with latex-perfused vasculature.
- Identification and application of anatomical landmarks in five hemispheric deafferentations.
- Detailed description of the central core's composition and surrounding structures.
Main Results:
- The central core includes internal capsules, claustrum, basal ganglia, and thalamus.
- Key landmarks identified: choroid plexus, tentorium, callosal sulcus, anterior cerebral artery, and caudate nucleus.
- These landmarks facilitate disconnection of frontal, parietal, and occipital lobes, and intraventricular fibers.
Conclusions:
- The proposed anatomical landmarks are applicable to various hemispherotomy techniques.
- These landmarks enable precise resection around the central core and tentorial incisura.