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The Cerebellopontine Angle: Basic Structures and the “Rules of Three”

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Microsurgical Anatomy and Surgery of the Posterior Cranial Fossa

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Abstract

Detailed knowledge of the surgical anatomy of the cerebellopontine angle (CPA) is vital for surgical treatment of CPA tumors and vertebral artery (VA) aneurysms and for microvascular decompression (MVD) surgeries [4, 7, 8, 11, 13, 18–20, 23]. CPA is a cistern that is surrounded by the petrous bone laterally and the petrosal (lateral) cerebellar surface and brainstem medially. Many cranial nerves (CNs), arteries, and veins run in this cistern [17]. First, the lateral and medial walls of CPA will be described; later, CNs and vessels, especially the basic relationships between nerves and arteries, will be explained. The microsurgical anatomies of the internal acoustic meatus and lateral part of the foramen magnum are described in detail in Chaps. 14 and 17, respectively. The microsurgical anatomy and surgeries for MVD are described in Chaps. 10–13.

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References

  1. Hardy DG, Peace DA, Rhoton AL Jr (1980) Microsurgical anatomy of the superior cerebellar artery. Neurosurgery 6:10–28

    Article  CAS  PubMed  Google Scholar 

  2. Hardy DG, Rhoton AL Jr (1978) Microsurgical relationships of the superior cerebellar artery and trigeminal nerve. J Neurosurg 49:669–678

    Article  CAS  PubMed  Google Scholar 

  3. Katsuta T, Rhoton AL Jr, Matsushima T (1997) The jugular foramen: Microsurgical anatomy and operative approaches. Neurosurgery 41:149–202

    Article  CAS  PubMed  Google Scholar 

  4. Kawashima M, Matsushima T, Inoue T, Mineta T, Masuoka J, Hirakawa N (2010) Microvascular decompression for glossopharyngeal neuralgia through the transcondylar fossa (supracondylar transjugular tubercle) approach. Neurosurgery 66(6 Suppl Operative):275–280

    PubMed  Google Scholar 

  5. Lister JR, Rhoton AL Jr, Matsushima T, Peace DA (1982) Microsurgical anatomy of the posterior inferior cerebellar artery. Neurosurgery 10:170–199

    Article  CAS  PubMed  Google Scholar 

  6. Martin RG, Grant JL, Peace DA, Theiss C, Rhoton AL Jr (1980) Microsurgical relationships of the anterior inferior cerebellar artery and the facial-vestibulocochlear nerve complex. Neurosurgery 6:483–507

    Article  CAS  PubMed  Google Scholar 

  7. Masuoka J, Matsushima T, Kawashima M, Nakahara Y, Funaki T, Mineta T (2011) Stitched sling retraction technique for microvascular decompression: procedures and techniques based on an anatomical viewpoint. Neurosurg Rev 34:373–379

    Article  PubMed  Google Scholar 

  8. Matsushima T (1999) Surgeries of the VA-PICA junction aneurysms and saccular aneurysms of the VA. In: Miyake E (ed) Microsurgical operation of cerebral aneurysms. KINPODO, Tokyo, pp 329–338 (in Japanese)

    Google Scholar 

  9. Matsushima T (2006) Microsurgical Anatomy and Surgery of the Posterior Fossa. SciMed Publications Inc, Tokyo (in Japanese)

    Google Scholar 

  10. Matsushima T, Fukui M, Fujii K, Inoue T, Suzuki S, Rhoton AL Jr (1992) Microsurgical anatomy of the veins of the posterior fossa – Special reference to bridging veins. Neurosurgeons 11:32–42 (in Japanese)

    Google Scholar 

  11. Matsushima T, Fukui M, Suzuki S, Rhoton AL Jr (1989) The microsurgical anatomy of the infratentorial lateral supracerebellar approach to the trigeminal nerve for tic douloureux. Neurosurgery 24:890–895

    Article  CAS  PubMed  Google Scholar 

  12. Matsushima T, Fukui M, Yamashita M (1987) Microsurgical neurovascular decompression for trigeminal neuralgia with special reference to infratentorial lateral supracerebellar approach. Neurol Surg 15:1047–1054 (in Japanese)

    CAS  Google Scholar 

  13. Matsushima T, Goto Y, Natori Y, Matsukado K, Fukui M (2000) Surgical treatment of glossopharyngeal neuralgia as vascular compression syndrome via transcondylar fossa (supracondylar transjugular tubercle) approach. Acta Neurochir (Wien) 142(12):1359–1363

    Article  CAS  Google Scholar 

  14. Matsushima T, Huynh-Le, Miyazono M (2004) Trigeminal neuralgia caused by venous compression. Neurosurgery 55:334–339

    Article  PubMed  Google Scholar 

  15. Matsushima T, Inoue T, Fukui M (1990) Arteries in contact with the cisternal portion of the facial nerve in autopsy cases: Microsurgical anatomy for neurovascular decompression surgery of hemifacial spasm. Surg Neurol 34:87–93

    Article  CAS  PubMed  Google Scholar 

  16. Matsushima T, Inoue T, Natori Y, Fukui M, Oliveira ED, Rhoton AL Jr (1992) Microsurgical anatomy for the region near the porus acusticus internus: arteries around the facial and acoustic nerves bundle. Neurol Surg 20:409–415 (in Japanese)

    CAS  Google Scholar 

  17. Matsushima T, Inoue T, Natori Y, Fukui M, Rhoton AL Jr (1994) Microsurgical Anatomy of the Cerebellopontine Angle, Surgical Anatomy for Microneurosurgery VI. SciMed Publications Inc, Tokyo, pp 134–145 (in Japanese)

    Google Scholar 

  18. Matsushima T, Inoue T, Suzuki S, Fujii K, Fukui M, Rhoton AL Jr (1992) Microsurgical Anatomy of the Cranial Nerves and Vessels in the Cerebellopontine Angle – Differences between the approaches of MVD for trigeminal neuralgia and for hemi facial spasm, Surgical Anatomy for Microneurosurgery IV. SciMed Publications Inc, Tokyo, pp 45–55 (in Japanese)

    Google Scholar 

  19. Matsushima T, Kawashima M, Inoue K, Matsushima K (2014) Anatomy of the superior petrosal veins and their exposure and management during petrous apex meningioma surgery using the lateral suboccipital retrosigmoid approach. Neurosurg Rev 37: 535–546. doi:10.1007/s10143-014-0548-4

    Article  PubMed  Google Scholar 

  20. Matsushima T, Matsukado K, Natori Y, Inamura T, Hitotsumatsu T, Fukui M (2001) VA-PICA saccular aneurysm surgery through either transcondylar fossa (supracondylar transjugular tubercle) or trans-condylar approach ─ Surgical results and indication using two different lateral skull base approaches. J Neurosurg 95:268–274

    Article  CAS  PubMed  Google Scholar 

  21. Matsushima T, Rhoton AL Jr, Oliveira ED, Peace D (1983) Microsurgical anatomy of the veins of the posterior fossa. J Neurosurg 59:63–105

    Article  CAS  PubMed  Google Scholar 

  22. Matsuno H, Rhoton AL Jr, Peace D (1988) Microsurgical anatomy of the posterior fossa cisterns. Neurosurgery 23:58–80

    Article  CAS  PubMed  Google Scholar 

  23. Rhoton AL Jr (1974) Microsurgical of the internal acoustic meatus. Surg Neurol 2:311–318

    PubMed  Google Scholar 

  24. Rhoton AL Jr (1986) Microsurgical anatomy of the brainstem surface facing an acoustic neuroma. Surg Neurol 25:326–339

    Article  PubMed  Google Scholar 

  25. Rhoton AL Jr, Buza R (1975) Microsurgical anatomy of the jugular foramen. J Neurosurg 42:541–550

    Article  PubMed  Google Scholar 

  26. Rhoton AL Jr, Kobayashi S, Hollinshead WH (1968) Nervus intermedius. J Neurosurg 29:609–618

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery Faculty of Medicine, Saga University, Saga, Japan

    Toshio Matsushima

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  1. Toshio Matsushima
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Matsushima, T. (2015). The Cerebellopontine Angle: Basic Structures and the “Rules of Three”. In: Microsurgical Anatomy and Surgery of the Posterior Cranial Fossa. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54183-7_8

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  • DOI: https://doi.org/10.1007/978-4-431-54183-7_8

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  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-54182-0

  • Online ISBN: 978-4-431-54183-7

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