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Microsurgical anatomy of the lateral posterior choroidal artery: implications for intraventricular surgery involving the choroid plexus

Yuanzhi Xu, Ahmed Mohyeldin, Ayoze Doniz-Gonzalez, Vera Vigo, Felix Pastor-Escartin, Lingzhao Meng, Aaron A Cohen-Gadol, and Juan C Fernandez-Miranda

its spatial relationships with the AChA, fimbria, crus of fornix , and pulvinar were carefully inspected. The diameter of the AChA and LPChA and the distance between them at the inferior choroidal point were measured with digital micrometer calipers. The LPChA was classified into normal, hypoplastic (defined as less than half of the diameter of the AChA), and hyperplastic (defined as larger than the diameter of the AChA). The patterns of the LPChA were divided into 3 types according to its location in relation to the choroidal fissure and the number of trunks

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Aventricular hemispherotomy: technical note

Cameron Brimley, Vivek P. Buch, Jared M. Pisapia, and Benjamin C. Kennedy

the incisura to serve as a landmark for the thalamomesencephalic disconnection ( Fig. 1C ), while the optic nerve served as a landmark for the anterior and inferior extent of the interhemispheric disconnection ( Figs. 1B , 1D , 2A , and 2E ). The posterior third ventricle was entered, bilateral thalami were identified, and the massa intermedia was divided. The interhemispheric fissure was followed anteriorly to identify the corpus callosum. The only fornix identified was on the patient’s right side and traced anteriorly to a point where it split to send a fiber

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Aventricular hemispherotomy: technical note

Cameron Brimley, Vivek P. Buch, Jared M. Pisapia, and Benjamin C. Kennedy

the incisura to serve as a landmark for the thalamomesencephalic disconnection ( Fig. 1C ), while the optic nerve served as a landmark for the anterior and inferior extent of the interhemispheric disconnection ( Figs. 1B , 1D , 2A , and 2E ). The posterior third ventricle was entered, bilateral thalami were identified, and the massa intermedia was divided. The interhemispheric fissure was followed anteriorly to identify the corpus callosum. The only fornix identified was on the patient’s right side and traced anteriorly to a point where it split to send a fiber

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Forniceal glioma in children

Clinical article

Thomas Blauwblomme, Pascale Varlet, John R. Goodden, Marie Laure Cuny, Helene Piana, Thomas Roujeau, Federico DiRocco, Jacques Grill, Virginie Kieffer, Nathalie Boddaert, Christian Sainte-Rose, and Stéphanie Puget

function. 1 , 2 , 4–6 We report a series of 8 children treated in the Hôpital Necker Enfants Malades, Paris, over a 17-year period. Their presentation, disease management, histological and radiological features, and outcomes are described. Methods We performed a retrospective analysis of all children who were treated surgically at Hôpital Necker for supratentorial glioma between 1990 and 2007. There were 250 patients, with only 8 having lesions involving the fornix. We excluded large tumors from other locations with forniceal extension. Histological findings

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Anterior interhemispheric transsplenial approach to pineal region tumors: anatomical study and illustrative case

Kaan Yağmurlu, Hasan A. Zaidi, M. Yashar S. Kalani, Albert L. Rhoton Jr., Mark C. Preul, and Robert F. Spetzler

glial tumors), velum interpositum (meningiomas), or fornix . The surgical approaches to pineal region pathology are intimately related to the complex anatomical relationship of the surgical target to surrounding structures, location of feeding blood supply, anatomical variations, and extent of resection goals. Numerous approaches to this region have been described, and they can be tailored to the morphology of the target lesion. These approaches include the supracerebellar infratentorial approach, occipital interhemispheric approach, parietooccipital

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The transcallosal—transforaminal approach to the third ventricle with regard to the venous variations in this region

Uğur Türe, M. Gazi Yaşargil, and Ossama Al-Mefty

sacrifice of the thalamostriate vein, 12, 17, 25 the transforaminal exposure with unilateral incision of the column of the fornix, 1, 11, 16, 27, 37, 38, 40, 41 the interforniceal exposure, 2–4, 6 the subchoroidal exposure, 10, 43 and the transchoroidal exposure. 33, 37 Each of these surgical techniques encompasses certain advantages and disadvantages. In this article we describe the anatomical variations of the subependymal veins of the lateral ventricle in the region of the foramen of Monro and analyze their significance in surgical exploration via a

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Rare large colloid cyst obstructing the posterior third ventricle: illustrative case

Jakob V. E. Gerstl, Kristian Aquilina, and Jeffrey E. Florman

be symptomatic, as even a small mass can cause obstruction, 11 a colloid cyst arising in the roof of the posterior ventricle requires significant size to be of clinical consequence. In addition to origin and size, the direction of cyst growth is relevant and often depends on the anatomical origin of the cyst as it relates to variance in the point of forniceal column divergence from the body of the fornix. 12 Normally, this point of divergence is relatively anterior, and a classic cyst arising anteriorly in the roof of the third ventricle therefore grows

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Interhemispheric transcallosal transchoroidal approach to a pineal teratoma in a 15-year-old boy

Giuseppe Cinalli, Maria Rosaria Scala, Alessandra Marini, Alessia Imperato, Giuseppe Mirone, and Pietro Spennato

working between the two internal cerebral veins would allow complete control of the tumor from the anterior to the posterior pole. The more posterior trajectory seems to cross the posterior column of the fornix, but dissection of the choroid fissure and the section of the anterior septal vein allows a very lateral displacement of the right internal cerebral vein, creating a very large operative corridor that allows to work always laterally to the posterior column of the fornix, minimizing the risks to injure it. 2:46 Position and Flap Position is supine, with mild

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Endoscopic bimanual sharp dissection technique for gross-total resection of colloid cysts: technical note

Sascha Marx and Henry W. S. Schroeder

( left ). The skin incision is marked ( right ). FIG. 4. Case 14. The screenshots show the insertion, under navigational guidance, of the endoscopic sheath into the right lateral ventricle. After removal of the trocar, the ventricle is inspected with the ventriculoscope. The steps of cyst removal are shown in drawings in Fig. 5 and in endoscopic images of a surgical case in Fig. 6 . The choroid plexus, fornix, and thalamostriate and septal veins are identified as the main landmarks ( Figs. 5A and 6A ). The choroid plexus covering the cyst and

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Transcavum interforniceal endoscopic surgery of the third ventricle

Clinical article

Mark M. Souweidane, Caitlin E. Hoffman, and Theodore H. Schwartz

These publications have justifiably focused on patients with normal intraventricular anatomy. Through such experience, the endoscopic surgeon has come to rely on the familiarity of the foramen of Monro with its surrounding structures of the choroid plexus, columns of the fornix, and septal and thalamostriate veins for safe transforaminal navigation into the third ventricle. An increasing reliance on endoscopic surgery in the third ventricle will demand that predictable anatomical variants are described with respect to the pertinent anatomy and their respective