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Related Concept Videos

Anatomy of the Brain: Ventricles01:18

Anatomy of the Brain: Ventricles

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There are hollow fluid-filled cavities known as ventricles deep inside the human brain. There are two lateral ventricles, one in each cerebral hemisphere, and each has three different projections — the anterior, inferior, and posterior horns visible from the lateral side. A thin membrane called the septum pellucidum separates the two lateral ventricles. The slender third ventricle in the diencephalon is connected to each lateral ventricle via a channel called the interventricular foramen.
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The Technique for Transorbital Ventricular Puncture: An Anatomic Approach.

Luís Gustavo Biondi Soares1,2, Vanessa Milanesi Holanda3, Gustavo Veloso Lages2

  • 1Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo , Brazil.

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Summary
This summary is machine-generated.

Transorbital puncture offers a minimally invasive method to relieve intracranial hypertension. This study provides key anatomical landmarks for safely accessing the lateral ventricle in emergency situations.

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Area of Science:

  • Neurosurgery
  • Emergency Medicine
  • Anatomy

Background:

  • Transorbital ventricular puncture is a minimally invasive procedure with limited anatomical guidance.
  • It offers a potential life-saving intervention for acute decompensated hydrocephalus and intracranial hypertension.

Purpose of the Study:

  • To define reliable anatomical structures and landmarks for executing transorbital puncture.
  • To facilitate the safe and effective use of this technique in emergency settings.

Main Methods:

  • Analysis of 120 head CT scans to identify optimal orbital roof entry points.
  • Cadaveric dissection and puncture (4 sides) to register angles, distances, and anatomical references.
  • Determination of specific needle trajectory for ventricular access.

Main Results:

  • Perforation point identified 2.5 cm (female) or 3.0 cm (male) lateral to the midline, inferior to the superciliary arch.
  • Optimal needle trajectory: 45° inferiorly, 20° medially, advancing 2.0 cm to bone, then 4.5 cm to the anterior horn of the lateral ventricle.
  • Established specific measurements and angles for safe ventricular entry.

Conclusions:

  • Reliable anatomical reference points for transorbital puncture have been established.
  • This technique provides a viable bedside approach to the anterior horn of the lateral ventricle for emergency intracranial pressure management.