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Surgical approaches to hypothalamic hamartomas

Scott D. Wait, Adib A. Abla, Brendan D. Killory, Peter Nakaji, and Harold L. Rekate

system guide the endoscope through the Monro foramen and into the third ventricle. Care must be exercised to avoid forcefully impinging the fornix at the anterior margin of the foramen. While the tip of the endoscope is in the third ventricle, the fornix is not visible. The entry point is chosen as described above because the fornix will not tolerate anterior “windshield wiping” of the endoscope. Gentle posterior “windshield wiping” movements are better tolerated but should be minimized. Once the third ventricle has been accessed, gentle irrigation will separate the

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Interhemispheric transcallosal intervenous approach to a pineal region tumor

Daniel A. Donoho and Guillermo Aldave

before the dissection of the velum interpositum in the midline, we expose also the right lateral ventricle as we can see. Once we have both lateral ventricles exposed, we move forward with the exposure of the tela choroidea in the roof of the third ventricle. Doing the midline dissection close to the splenium of the corpus callosum it is always safe, as the body of the fornices should have already left the midline and turned into the crus of the fornix in the anterior wall of the atrium. 6 In this dissection of the velum interpositum, we can identify all the layers

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Bilateral occlusion of the foramina of Monro after third ventriculostomy

Case report

Ehab El Refaee, Joerg Baldauf, and Henry W. S. Schroeder

was done to avoid injury to the fornix. To avoid reclosure of the foramen, a silicon stent was inserted between the 2 ventricles ( Fig. 5C ) to ensure a durable connection between the left lateral and the third ventricle. The stent was fixed to a Rickham reservoir to prevent migration of the stent. F ig . 5. Endoscopic images obtained during the second surgery (foraminoplasty and stenting), showing the obstructed left foramen of Monro (A) , the fenestrated septum pellucidum (B) , and a stent within the location of the left foramen of Monro (C

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Quantitative anatomical comparison of the ipsilateral and contralateral interhemispheric transcallosal approaches to the lateral ventricle

Evgenii Belykh, Kaan Yağmurlu, Ting Lei, Sam Safavi-Abbasi, Mark E. Oppenlander, Nikolay L. Martirosyan, Vadim A. Byvaltsev, Robert F. Spetzler, Peter Nakaji, and Mark C. Preul

. Photograph of cadaveric dissection showing the lateral wall of the left lateral ventricle. Part of the corpus callosum and the cingulate gyrus were removed and the body of the fornix was resected to expose the lateral ventricle wall. Projection of the 15-mm-long callosotomy is depicted. Approximate positions of the 7 points that define the area of exposure are as follows: A, the uppermost posterior reachable point; B, the uppermost point on the lateral wall at the middle of the callosotomy; C, the uppermost anterior reachable point; D, the lowermost posterior reachable

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Meningioma of the Free Margin of the Cerebellar Tentorium

Béla Halpert, Harry Wilkins, and A. C. Lisle Jr.

the cavities of the lateral ventricles. There was a shift to the right of the septum pellucidum and of the cavity of the 3rd ventricle. The cavity of the anterior horn of the right ventricle was 1.5 by 2, that of the left 2 by 0.8, and that of the 3rd ventricle, 2 by 0.6 cm. About 2 cm. posterior to the level of the optic chiasm a well circumscribed, globular mass, 5 by 4.5 cm., occupied the space beneath the corpus callosum and fornix between the cerebral hemispheres and the pons ( Fig. 2 ). Its cut surfaces had a gray streaked or whorl-like appearance. The mass

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Microsurgical anatomy of the region of the tentorial incisura

Michio Ono, Makiko Ono, Albert L. Rhoton Jr., and Margaret Barry

.), carotid arteries (Car. A.), and infundibulum (Infund.) of the pituitary gland cross the anterior incisural space. The middle incisural space is located lateral to the midbrain. It extends into the supratentorial area between the temporal lobe and the midbrain and into the infratentorial area between the cerebellum and the brain stem. The posterior incisural space is located between the apex of the tentorium posteriorly, the midbrain anteriorly, the splenium above, and the cerebellum below. The corpus callosum (Corp. Call.), septum pellucidum (Sept. Pell.), and fornix

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Editorial: Hypothalamic hamartomas

Harold L. Rekate

significant roles. The approach presented here by Roth et al. 2 is a hybrid between the transcallosal interforniceal approach and a purely endoscopic transventricular approach. The procedure is analogous to the “endoscopic assisted” surgical procedures advocated by contemporary skull base surgeons. There is no need to separate the columns of the fornix, which theoretically would make this procedure less likely to lead to severe difficulties with short-term memory than the transcallosal interforniceal approach, since you begin by entering the lateral ventricle. Depending

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Surgical anatomy and functional connectivity of the limbic system

Karl-Olof Lövblad and Karl Schaller

callosi into the subcallosal region. The fimbriae of the hippocampus, as they move posteriorly along the choroidal fissure, become the crura of the fornix. The crura constitute the anterior and medial aspect of the anterior wall of the ventricular atrium, 24 and move upward and join in the midline inferior to the splenium of the corpus callosum , and then run anteriorly and inferiorly to the mammillary bodies. The Parahippocampus This structure starts with the uncus , of which it represents the major portion , and thus represents the inferomedial surface of

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Embryological development of the human insula and its implications for the spread and resection of insular gliomas

M. Yashar S. Kalani, Maziyar A. Kalani, Ryder Gwinn, Bart Keogh, and Victor C. K. Tse

representation of the development of the telencephalon. The rotation of the expanding telencephalon (dark blue arrow) pulls the archicortex, which is initially located at the medial wall of the ventricle toward the mesial temporal region. The fornix remains as the remnant of this connection. The expansion and rotation of the telencephalon in a posterior, lateral, and inferior manner occurs between the 14th and 16th week of gestation, with the concomitant appearance of the sylvian fissure at the 3rd and 4th month respectively. 30 , 34 The earlier linear furrow on the

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Embryological development of the human insula and its implications for the spread and resection of insular gliomas

M. Yashar S. Kalani, Maziyar A. Kalani, Ryder Gwinn, Bart Keogh, and Victor C. K. Tse

representation of the development of the telencephalon. The rotation of the expanding telencephalon (dark blue arrow) pulls the archicortex, which is initially located at the medial wall of the ventricle toward the mesial temporal region. The fornix remains as the remnant of this connection. The expansion and rotation of the telencephalon in a posterior, lateral, and inferior manner occurs between the 14th and 16th week of gestation, with the concomitant appearance of the sylvian fissure at the 3rd and 4th month respectively. 30 , 34 The earlier linear furrow on the