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Microsurgical anatomy of the transcallosal approach to the ventricular system, pineal region and basal ganglia

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Abstract

Vascular and neoplastic lesions of the lateral and III ventricles, the pineal region, or the basal ganglia affect highly critical areas. For surgical treatment of these lesions, the interhemispheric, transcallosal approach was studied in our laboratory in an attempt to evaluate the surgical procedure. The advantages and disadvantages are described in comparison with those for other approaches in the same regions. To this end, we dissected 20 anatomical specimens interhemispherically using the surgical microscope (with a magnification of 6× to 25×); the specimens were fixed for 6–8 weeks in formaldehyde 10%). In each specimen the corpus callosum was exposed and then sectioned to a length of 2 to 2.5 cm over its anterior, middle, and posterior thirds. The anatomy of the lateral and III ventricles and of the pineal region was explored; the arrangement configuration of the anterior cerebral arteries and their branches was also evaluated, as were the thalamostriate and other subependymal veins, the internal cerebral veins, the choroid plexus, the trigone, and the septum pellucidum.

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References

  1. 1.

    Antunez JL, Louis KM, Ramaiah Ganti S (1980) Colloid cysts of the third ventricle. Neurosurgery 7:450–455

  2. 2.

    Apuzzo MLJ (1982) Transcallosal interfornicial approaches for lesions affecting the third ventricle. In: Schmidek HH (ed) Operative neurological techniques: indications and methods. Grune & Stratton, New York

  3. 3.

    Apuzzo MLJ, Chikovani OK, Gott PS, Teng EL, Zee CS, Gianotta SL, Weiss MH (1982) Transcallosal interfornicial approaches for lesions affecting the third ventricle. Surgical considerations and consequences. Neurosurgery 10:547–554

  4. 4.

    Balado M (1928) Radiografia del tercer ventriculo mediante la inyección intraventricular de lipiodol. Arch Arg Neurol 2:11

  5. 5.

    Balado M (1931) Anatomia clínica y radiológica del tercer ventrículo. Semana Médica 38:413–427

  6. 6.

    Balado M (1931) Sobre el tratamiento quirúrgico de los tumores del tercer ventrículo. Bol Inst Clin Quirúrg (Buenos Aires) 9:5–9

  7. 7.

    Baldwin M, Ommaya AK, Farrier R, MacDonald FJ (1963) Mesial cerebral incision. J Neurosurg 20:679–686

  8. 8.

    Baumgartner J, Toumade A, Plas JY (1981) Etude anatomochirurgicale de la voie d'abord de la toile choroidienne supérieure de de 3e. ventricule. A propos de un aneurysme artérioveineux choroidien postérieur. Neurochirurgie 27:97–102

  9. 9.

    Benes V (1982) Sequelae of transcallosal surgery. Child's Brain 9:69–72

  10. 10.

    Busch EA (1944) New approach for the removal of tumors of the third ventricle. Acta Psychiatr Scand 19:57–60

  11. 11.

    Cairns H, Mosberg WH (1951) Colloid cysts of the third ventricle. Surg Gynecol Obstet 92:545–570

  12. 12.

    Caron JP, Debrun G, Sichez JP, Comoy J (1973) Ligature des veines cerebrales internes et survie. A propos de deux pinealomectomies. Neurochirurgie 20:81–90

  13. 13.

    Cashion EL, Young JM (1971) Intraventricular craneopharingioma. J Neurosurg 34:84

  14. 14.

    Ciric I (1980) Comment. Neurosurgery 7:455

  15. 15.

    Ciric I, Zivin I (1975) Neuroepithelial (colloid) cyst of the septum pellucidum. J Neurosurg 43:69–73

  16. 16.

    Cuatico G, Castan P (1962) Choroid plexus papilloma of third ventricle. J Neurosurg 19:1085–1087

  17. 17.

    Damasio AR, Chui HC, Corbett J, Kassel N (1980) Posterior callosal section in a non-epileptic patient. J Neurol Neurosurg Psychiatry 43:351–356

  18. 18.

    Dandy WE (1921) An operation for the removal of pineal tumors. Surg Gynecol Obstet 33:113–118

  19. 19.

    Dandy WE (1922) Diagnosis, localization and removal of tumors of the third ventricle. Bull John Hopkins Hosp 375:188–189

  20. 20.

    Dandy WE (1929) Mechanisms and symptoms of tumors of the third ventricle and pineal body. Intracranial pressure in health and disease. Williams & Wilkins, Baltimore

  21. 21.

    Dandy WE (1933) Benign tumors in the 3rd ventricle of the brain. Diagnosis and treatment. Thomas, Springfield, Illinois

  22. 22.

    Dandy WE (1936) Operative experience in cases of pineal tumors. Arch Surg 33:19–46

  23. 23.

    Dandy WE (1945) Tumors of the third ventricle. In: Surgery of the brain. (Lewis practice of surgery, vol I) Prior

  24. 24.

    Delandsheer JM, Guyot JF, Jomin M, Scherpereel B, Laine E (1978) Acces au troisieme ventricule par voie inter-thalamotrigonale. Neurochirurgie 24:419–422

  25. 25.

    Dimond SJ, Scammel ER, Brouwers EYM, Weeks R (1977) Functions of the centre section (trunk) of the corpus callosum in man. Brain 100:543–562

  26. 26.

    Dunker RO, Harris AB (1976) Surgical anatomy of the proximal anterior cerebral artery. J Neurosurg 44:359–367

  27. 27.

    Ehni G (1978) Comment. Neurosurgery 3:343

  28. 28.

    Faris AA, Bale GF, Cannon B (1971) Arachnoidal cyst of the 3rd ventricle with precocious puberty. South Med J 64:1139

  29. 29.

    Ferry DJ Jr, Mylander K, Hardman J (1972) Radiographic identification and surgical removal of a teratoid tumor of the roof of the 3rd ventricle. Case Report. J Neurosurg 36:231

  30. 30.

    Fujii K, Leukey C, Rhoton AL Jr (1980) Microsurgical anatomy of the choroidal arteries: lateral and third ventricles. J Neurosurg 52:165–188

  31. 31.

    Garcia Bengoechea F, De la Torre O, Esquivel O, Vieta R, Fernandez C (1954) The section of the fornix in the surgical treatment of certain epilepsies. Trans Am Neurol Assoc 79:176

  32. 32.

    Gazzaniga MS, Risse GL, Springer SP, Clark E, Wilson DH (1975) Psychologic and neurologic consequences of partial and complete cerebral commissurotomy. Neurology (NY) 25:10–15

  33. 33.

    Geffen G, Walsh A, Sipson D, Jeeves M (1980) Comparison of the effects of transcortical and transcallosal removal of intraventricular tumors. Brain 103:773–788

  34. 34.

    Giudicelli G, Salamon G (1970) The veins of the thalamus. Neuroradiology 1:92–98

  35. 35.

    Godersky JC, Rockswold G, Larson DA (1980) Xanthogranuloma of the third ventricle producing hydrocephalus. Neurosurgery 7:68–70

  36. 36.

    Gordon HW, Bogen JE, Sperry RV (1971) Absence of disconnection syndrome in two patients with partial section of the neocommissures. Brain 94:327–336

  37. 37.

    Gradin WC, Taylor C, Frain AH (1983) Choroid plexus papilloma of the third ventricle: case report and review of the literature. Neurosurgery 12:217–220

  38. 38.

    Greenwood J (1949) Paraphysial cysts of the third ventricle with report of eight cases. J Neurosurg 6:153–159

  39. 39.

    Greenwood J (1950) Removal of foreign body (bullet) from the third ventricle. J Neurosurg 7:169:172

  40. 40.

    Greenwood J (1973) Radical surgery of tumors of the thalamus, hypothalamus, and third ventricle area. Surg Neurol 1:29–33

  41. 41.

    Harbaugh RE, Wilson DH (1982) Telencephalic theory of generalized epilepsy: observations on split-brain patients. Neurosurgery 10:725–733

  42. 42.

    Heilman KM, Sypert GW (1977) Korsakoff's syndrome resulting from bilateral fornix lesions. Neurology 27:490–493

  43. 43.

    Hirsch JF, Zouaoui A, Renier D, Pierre-Kahn AA (1979) New surgical approach to the third ventricle with interruption of the strio-thalamic vein. Acta Neurochir (Wien) 47:135–147

  44. 44.

    Isamat F (1979) Tumours of the posterior part of the third ventricle. Neurosurgical criteria. (Advances and technical standards in Neurosurgery, vol 6) Springer, Wien New York

  45. 45.

    Jeeves MA, Simpson DA, Geffen G (1979) Functional consequences of the transcallosal removal of the intraventricular tumours. J Neurol Neurosurg Psychiatry 42:134–142

  46. 46.

    Jomin M, Lesoin F, Delaud JM, Laine E (1980) Intérét de la voie interthalamo-trigionale dans le traitement des tumeurs de troisieme ventricule et de la region epiphysaire. Neurochirurgie 26:171–177

  47. 47.

    King TT (1979) Removal of intraventricular craniopharyngiomas through lamina terminalis. Acta Neurochir (Wien) 5:277–286

  48. 48.

    Lavyne MH, Patterson RH (1983) Subchoroidal trans-velum interpositum approach to mid-third ventricular tumors. Neurosurgery 12:86–94

  49. 49.

    Little JR, MacCarthy CS (1974) Colloid cysts of the third ventricle. J Neurosurg 40:230–235

  50. 50.

    Long DM, Chou SN (1973) Transcallosal removal of craniopharyngiomas within the third ventricle. J Neurosurg 39:563–567

  51. 51.

    Marino R Jr (1976) The anterior cerebral artery. I. Anatomoradiological study of its cortical territories. Surg Neurol 5:81–87

  52. 52.

    Martel T de, Guillaume J (1933) Tumeur developpee dans le IIIe ventricule. Abord par voie trans-calleuse. Ablation partielle, guerison. Rev Neurol 2:847–852

  53. 53.

    McKissock W (1951) The surgical treatment of colloid cysts of the third ventricle. Brain 74:1–9

  54. 54.

    Milhorat IH, Baldwin MA (1966) Technique for surgical exposure of the cerebral midline. Experimental transcallosal microdissection. J Neurosurg 24:687–691

  55. 55.

    Napoleone F (1961) L'apertura del terzo ventricolo per via superiore. Ann Neurol Psichiatr (Perugia) 55:331

  56. 56.

    Obenchain TG, Becker DP (1972) Head bobbing associated with cyst of the 3rd ventricle. J Neurosurg 37:457

  57. 57.

    Pecker J, Ferraud B, Javalet A (1966) Tumeurs du troisieme ventricule. Neurochirurgie 12:1–136

  58. 58.

    Perlmutter D, Rhoton AL Jr (1976) Microsurgical anatomy of the anterior cerebral-anterior communicating recurrent artery complex. J Neurosurg 45:259–272

  59. 59.

    Perlmutter D, Rhoton AL Jr (1978) Microsurgical anatomy of the distal anterior cerebral artery. J Neurosurg 49:204–228

  60. 60.

    Rhoton AL Jr (1982) Comment. Neurosurgery 10:554

  61. 61.

    Rhoton AL Jr (1983) Comment. Neurosurgery 12:93

  62. 62.

    Rhoton AL Jr, Yamamoto I, Peace DA (1981) Microsurgery of the third ventricle. II. Operative approaches. Neurosurgery 8:357–373

  63. 63.

    Schnitker MT (1950) Encasement of foreign body (bullet) in the third ventricle for 9 years. J Neurosurg 7:173–174

  64. 64.

    Sehrbundt Viale E, Pau A (1979) Approccio chirurgico al terzo ventricolo per via subcoroidea. S Sassaresi 56:397

  65. 65.

    Shuangehoti S, Dharmmaponpilas JA (1976) 12 y/o boy with two lipomas in the 3rd ventricle. Clin Pediatr 15:459

  66. 66.

    Shucart WA, Stein BM, Trans BM (1978) Transcallosal approach to the anterior ventricular system. Neurosurgery 3:339–343

  67. 67.

    Sinha RP, Keller DW, Ducker TB, Perot PL Jr (1976) 3rd ventricular meningioma. A case report. J SC Med Assoc 72:427

  68. 68.

    Stein BM (1977) Transcallosal approach to third ventricular tumors. In: Schmidek HH, Sweet WH (eds) Current techniques in operative neurosurgery. Grune & Stratton, New York, pp 247–255

  69. 69.

    Stein BM, Fraster RAR, Tenner MS (1972) Tumours of the third ventricle in children. J Neurol Neurosurg Psychiatry 35:776–788

  70. 70.

    Stephens RB, Stilwell DL (1969) Arteries and veins of the human brain. Thomas, Springfield, Illinois

  71. 71.

    Sweet WH, Talland GA, Ervin FR (1959) Lose of recent memory following section of fornix. Trans Am Neurol Assoc 84:76

  72. 72.

    Trescher JH, Ford FR (1937) Colloid cyst of the third ventricle. Report of a case: operative removal with section of posterior half of corpus callosum. Arch Neurol Psychiatry 37:959–973

  73. 73.

    Umbach WL (1966) Long term results of fornicotomy for temporal epilepsy. Conf Neurol 127:121–123

  74. 74.

    Van Wagenen WP (1940) Surgical division of commissural pathways in the corpus callosum. Arch Neurol Psychiatry 44:740–759

  75. 75.

    Viale GL, Turtas S (1980) The subchoroid approach to the third ventricle. Surg Neurol 14:71–76

  76. 76.

    Wilson DH, Gazzaniga M (1978) Division of the corpus callosum for uncontrollable epilepsy. Neurology 28:649–653

  77. 77.

    Winston KR, Cavazzuti V, Arkins T (1979) Absence of neurological and behavioral abnormalities after anterior transcallosal operation for third ventricular lesions. Neurosurgery 4:386–393

  78. 78.

    Yamagiwa H (1967) Teratoma originated from the floor of the 3rd ventricle. Mie Med J 17:57

  79. 79.

    Yamamoto I, Rhoton AL Jr, Peace DA (1981) Microsurgery of the third ventricle. I. Microsurgical anatomy. Neurosurgery 8:334–356

  80. 80.

    Yasargil MG, Jain KK, Antic J, Laciga J (1976) Arterio-venous malformations of the splenium of the corpus callosum: microsurgical treatment. Surg Neurol 5:5–14

  81. 81.

    Zaidel D, Sperry KW (1974) Memory impairment after commissurotomy in man. Brain 97:263–272

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Correspondence to Edgardo Schijman.

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Schijman, E. Microsurgical anatomy of the transcallosal approach to the ventricular system, pineal region and basal ganglia. Child's Nerv Syst 5, 212–219 (1989). https://doi.org/10.1007/BF00271022

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Key words

  • Corpus callosum
  • Lateral ventricle
  • Microsurgery
  • Microsurgical anatomy
  • Pineal region
  • Surgical approaches
  • III ventricle