Advertisement

Surgical and Radiologic Anatomy

, Volume 40, Issue 7, pp 829–834 | Cite as

Dorsal extensions of the fastigium cerebelli: an anatomical study using magnetic resonance imaging

  • Satoshi Tsutsumi
  • Juan Carlos Fernandez-Miranda
  • Hisato Ishii
  • Hideo Ono
  • Yukimasa Yasumoto
Original Article
  • 58 Downloads

Abstract

Background and purpose

The fastigium cerebelli is an important topographical landmark for neurosurgeons and radiologists. However, few studies have characterized the morphology of the fastigium cerebelli. We aimed to investigate the fastigium cerebelli using postmortem specimens and magnetic resonance imaging (MRI) in vivo.

Materials and methods

Three cadaveric brains were midsagittally sectioned for observing the fastigium cerebelli. Additionally, 66 outpatients underwent MRI, including sagittal T1-weighted imaging, axial T2-weighted imaging, and coronal constructive interference in steady-state (CISS) sequence.

Results

In the cadaveric specimens, the fastigium cerebelli was observed as a beak-like dorsal protrusion of the fourth ventricle. Its inner surface was observed as a small fovea. On serial CISS images, the fastigium cerebelli consistently possessed a pair of triangular-shaped, dorsal extensions lying parasagittally along the nodule. These extensions were classified as symmetrical, right-side dominant, or left-side dominant. The symmetrical type was the most predominant and comprised 60.6% of the extensions, while the right-side dominant and left-side dominant types comprised 13.6 and 25.8%, respectively. In 91% of the 66 patients, the number of slices covering the entirety of the dorsal extensions were the same on both sides. The fastigial angle (θ) formed by lines tangent to the superior and inferior medullary velums varied widely.

Conclusions

The fastigium cerebelli has a pair of dorsal extensions lying parasagittally along the nodule. Coronal CISS sequence is useful in delineating the fastigium cerebelli in vivo.

Keywords

Fastigium cerebelli Dorsal extensions Morphological variations MRI 

Notes

Acknowledgements

This study did not receive any grant funding.

Author contributions

ST and JCF-M developed the project of study. JCF-M performed cadaver dissection and collected anatomical data. HI and YY collected the imaging data. HO and HI analyzed the imaging data. ST wrote the manuscript.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare regarding the materials or methods in this study or the findings specified in this paper.

References

  1. 1.
    Brocklehurst G (1969) The development of the human cerebrospinal fluid pathway with particular reference to the roof of the fourth ventricle. J Anat 105:467–475PubMedPubMedCentralGoogle Scholar
  2. 2.
    Casselman JW, Kuhweide R, Deimling M, Ampe W, Dehaene I, Meeus L (1993) Constructive interference in steady state-3DFT MR imaging of the inner ear and cerebellopontine angle. AJNR Am J Neuroradiol 14:47–57PubMedGoogle Scholar
  3. 3.
    Chen X, Hou X, Gao W, Zhu M, Wang Y, Wang H, Wang X, Lin Z (2010) Morphology of the adult midsagittal brainstem in relation to the reference systems MRI-based variability study. Acad Radiol 17:708–717CrossRefPubMedGoogle Scholar
  4. 4.
    Diedrichsen J, Maderwald S, Küper M, Thürling M, Rabe K, Gizewski ER, Ladd ME, Timmann D (2011) Imaging the deep cerebellar nuclei: a probabilistic atlas and normalization procedure. Neuroimage 54:1786–1794CrossRefPubMedGoogle Scholar
  5. 5.
    Glickstein SB, Ilch CP, Reis DJ, Golanov EV (2001) Stimulation of the subthalamic vasodilator area and fastigial nucleus independently protects the brain against focal ischemia. Brain Res 912:47–59CrossRefPubMedGoogle Scholar
  6. 6.
    Iadecola C, Underwood MD, Reis DJ (1986) Muscarinic cholinergic receptors mediate the cerebrovasodilation elicited by stimulation of the cerebellar fastigial nucleus in rat. Brain Res 368:375–379CrossRefPubMedGoogle Scholar
  7. 7.
    Laborde G, Gilsbach JM, Harders A, Seeger W (1992) Experience with the infratentorial supracerebellar approach in lesions of the quadrigeminal region, posterior third ventricle, culmen cerebelli, and cerebellar peduncle. Acta Neurochir (Wien) 114:135–138CrossRefGoogle Scholar
  8. 8.
    Leung V, Magnussen JS, Stoodley MA, Bilston LE (2016) Cerebellar and hindbrain motion in Chiari malformation with and without syringomyelia. J Neurosurg Spine 24:546–555CrossRefPubMedGoogle Scholar
  9. 9.
    Matsushima T, Rhoton AL Jr, Lenkey C (1982) Microsurgery of the fourth ventricle: part 1. Microsurgical anatomy. Neurosurgery 11:631–667CrossRefPubMedGoogle Scholar
  10. 10.
    Mussi AC, Rhoton AL Jr (2000) Telovelar approach to the fourth ventricle: microsurgical anatomy. J Neurosurg 92:812–823CrossRefPubMedGoogle Scholar
  11. 11.
    Niemann K, van den Boom R, Haeselbarth K, Afshar F (1999) A brainstem stereotactic atlas in a three-dimensional magnetic resonance imaging navigation system: first experiences with atlas-to-patient registration. J Neurosurg 90:891–901CrossRefPubMedGoogle Scholar
  12. 12.
    O’Rahilly R, Müller F (1990) Ventricular system and choroid plexuses of the human brain during the embryonic period proper. Am J Anat 189:285–302CrossRefPubMedGoogle Scholar
  13. 13.
    Roelants JA, Koning IV, Raets MM, Willemsen SP, Lequin MH, Steegers-Theunissen RP, Reiss IK, Vermeulen MJ, Govaert P, Dudink J (2016) A New Ultrasound marker for bedside monitoring of preterm brain growth. AJNR Am J Neuroradiol 37:1516–1522CrossRefPubMedGoogle Scholar
  14. 14.
    Salma A, Yeremeyeva E, Baidya NB, Sayers MP, Ammirati M (2013) An endoscopic, cadaveric analysis of the roof of the fourth ventricle. J Clin Neurosci 20:710–714CrossRefPubMedGoogle Scholar
  15. 15.
    Tepper R, Kidron D, Hershkovitz R (2009) Sonographic measurements of the fetal fastigium between 20 and 40 weeks’ gestation. J Ultrasound Med 28:1657–1661CrossRefPubMedGoogle Scholar
  16. 16.
    Tubbs RS, Bosmia AN, Loukas M, Hattab EM, Cohen-Gadol AA (2013) The inferior medullary velum: anatomical study and neurosurgical relevance. J Neurosurg 118:315–318CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Satoshi Tsutsumi
    • 1
  • Juan Carlos Fernandez-Miranda
    • 2
  • Hisato Ishii
    • 1
  • Hideo Ono
    • 3
  • Yukimasa Yasumoto
    • 1
  1. 1.Department of Neurological SurgeryJuntendo University Urayasu HospitalUrayasuJapan
  2. 2.Department of Neurological SurgeryUniversity of Pittsburgh School of Medicine, University of Pittsburg Medical CenterPittsburghUSA
  3. 3.Division of Radiological TechnologyMedical Satellite Yaesu ClinicTokyoJapan

Personalised recommendations