Anatomía microquirúrgica en 3D de la superficie cerebral / Microsurgical anatomy in 3D of the brain cortex

Introducción: El estudio de la superficie externa del cerebro es analizado desde diferentes puntos espaciales, es decir unasuperficie lateral, medial y basal. La superficie lateral del cerebro se distingue por la presencia de dos puntos de referencia quedividen a cada hemisferio cerebral en lóbulos. Estos dos puntos son la fisura de Silvio (fisura lateral) y el surco de Rolando (surcocentral). Estos dos surcos dividen a cada hemisferio en lóbulo frontal (superior a la fisura de Silvio y anterior al surco de Rolando),el lóbulo temporal (inferior a la fisura de Silvio) y lóbulo parietal (superior a la fisura de Silvio y posterior al surco de Rolando). Ellóbulo occipital se ubica por detrás del surco parietooccipital, y el lóbulo de la ínsula que se sitúa en la profundidad de la fisurade Silvio. Objetivo: Describir la anatomía Microquirúrgica de la superficie cerebral en imágenes estereoscópicas anaglíficas tridimensionales.Material y Métodos: La superficie cerebral fue examinada en 30 cerebros humanos con la ayuda de microscopioquirúrgico D.F. Vasconcellos M900 con una magnificación de 16x y 40x, el equipo fotográfico marca Nikon modelo D60, lenteAF-S VR Micro-Nikkor 105 mm f/2.8G IF-ED de Nikon, instrumental de microcirugía y sistema de vernier calibrado en décimasde milímetros. Resultados: La superficie cerebral de cada hemisferio esta dividida por medio de la fisura de Silvio y el surco deRolando en; Lóbulo frontal que se localiza superior a la fisura de Silvio y anterior al surco de Rolando, el lóbulo temporal que sesitúa inferior a la fisura de Silvio, lóbulo parietal de localización superior a la fisura de Silvio y posterior al surco de Rolando, el lóbulooccipital se ubica por detrás del surco parietooccipital. En la profundidad de la fisura de Silvio se encuentra el lóbulo de la ínsula...

Introduction: Brain cortex is studied from different views: lateral, medial and basal surfaces. The brain lateral surface is distinguished by the presence of referential points and sulci. Those specific surgical points consist of the Sylvian fissure (lateral fissure) and the Rolandic sulcus (central sulcus). Those sulci divide each hemisphere in frontal lobe (superior to the Sylvian fissure and anterior to the Rolandic sulcus), temporal lobe (inferior to the Sylvian fissure), and parietal lobe (superior to the Sylvian fissure and posterior to the Rolandic sulcus). The occipital lobe is located posteriorly to the parietooccipital sulci, and the insular lobe is located deep into the Sylvian fissure. Objetive: To describe the microsurgical anatomy of the brain cortex in tridimensional surface imaging reconstruction. Material and Methods: Human cadaveric speciments of 30 human brains were studied through the surgical microscopy D.F. Vasconcellos M900, 16x and 40x magnification, Nikon D60 camera, AF-S VR Micro-Nikkor 105 mm f/2.8G IF-ED lens, and microsurgical instruments. Results: Brain surface is divided in each hemisphere basically through the Sylvian fissure and the Rolandic sulcus in frontal lobe, superiorly to the to the Sylvian fissure and anteriorly to the Rolandic sulcus, temporal lobe, inferiorly to the Sylvian fissure, parietal lobe, superiorly to the Sylvian fissure and posteriorly to the Rolandic sulci, and occipital lobe behind the parietooccipital sulci. Deep into the Sylvian fissure is located the insular lobe...

Intracranial aneurysm and arachnoid cyst: a rare association between two cerebral malformations.

Intracranial aneurysms and arachnoid cysts are cerebral disorders of a high prevalence. However, association between both malformations is a rare finding. The aim was to analyse this association with regard to the different clinical presentations according to the haemorrhage types, as well as the pathogenesis of this association. We searched the English language literature in MEDLINE database in order to include all manuscripts in which this association was found. A new case of a 55-year-old man with a large posterior communicating artery aneurysm and a middle cranial fossa arachnoid cyst presenting with headache and seizure was added to review of the literature and presented as an illustrative case. Nine cases were found. Six were male and three were female. The mean age was 42 years (range 29-66 years). All but one arachnoid cysts were located at middle cranial fossa, aneurysms arose from middle cerebral artery in three cases, internal carotid artery bifurcation in two cases, posterior communicating segment of carotid artery in two cases, anterior communicating artery in one case and azygos pericallosal artery in one case. Clinical presentation was related to aneurysmal rupture in six cases (subarachnoid haemorrhage in four, subdural haematoma in one and intracystic haematoma in two) and related to arachnoid cysts in three cases, where the most common symptoms were seizures and headache. Association between intracranial aneurysms and arachnoid cysts is a rare finding that can present with signs and symptoms related to aneurysm rupture, or with mass effect and seizures related to the cyst. The aneurysmal haemorrhage may be atypical, since it can be into the subarachnoid space, into the arachnoid cyst, or into the subdural space.