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Related Experiment Video

Updated: Jul 2, 2026

Translational Brain Mapping at the University of Rochester Medical Center: Preserving the Mind Through Personalized Brain Mapping
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The pterional-transsylvian approach: an analytical study.

Eberval Gadelha Figueiredo1, Pushpa Deshmukh, Joseph M Zabramski

  • 1Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA.

Neurosurgery
|August 22, 2008
PubMed
Summary

Splitting the sylvian fissure (SF) during pterional (PT) approaches significantly improves surgical exposure up to the anterior ascendant ramus. Further splitting offers no additional benefit for neurosurgical procedures.

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Area of Science:

  • Neurosurgery
  • Surgical Anatomy
  • Microsurgery

Background:

  • The pterional (PT) approach is a common neurosurgical technique.
  • Splitting the sylvian fissure (SF) enhances surgical exposure in PT approaches.
  • Quantifiable data on the optimal extent of SF splitting is lacking.

Discussion:

  • This study quantifies the impact of progressive SF splitting on surgical exposure.
  • Measurements included the exposure area of the circle of Willis and angles of approach.
  • Brain retraction parameters were standardized to isolate the effect of SF splitting.

Key Insights:

  • Surgical exposure of the circle of Willis and carotid bifurcation significantly improves with SF splitting up to the anterior ascendant ramus.
  • Further splitting beyond the anterior ascendant ramus yields no significant additional exposure.

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  • Quantitative analysis provides evidence-based guidance for SF dissection during PT craniotomy.

    • Outlook:

    • Findings can refine surgical techniques for pterional approaches.
    • Optimizing SF splitting may reduce operative time and brain retraction injury.
    • Further research could explore the impact of SF splitting on specific pathologies.