Microsurgical Anatomy of the Pineal and Midbrain Region

Abstract

The surgical removal of lesions in the pineal region was and still is considered to be both dangerous and tedious. Even more so are intrinsic lesions within the midbrain. But since microsurgical techniques have renewed the debate, with the aid of technical advances in neuroimaging, anesthesia and postoperative care, it has become necessary to provide a more detailed anatomical knowledge of this region (Pendl 1984, 1985; Quest and Kleriga 1980; Rhoton et al. 1981; Yamamoto et al. 1981). Knowledge of the vascular structures and their microtopographic relationships, and knowledge of the finer anatomical structures for microsurgical dissection must be provided, not only in order to select the proper approach to this region of the pineal gland and the midbrain, but also to avoid further morbidity. Emphasis must be given to the vein of Galen and its tributaries, since they are a key to the success of surgery.