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Tumors of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Common sites of origin include: Skull base: Tuberculum sella/olfactory groove.Sphenoid wing or ridge: may grow into the orbit/optic nerve; cavernous sinus.Petrous ridge: often grows into cerebellopontine angle.Foramen magnum.Cerebral convexity.Falx cerebri.Tentorium cerebelli.Spine (usually thoracic and located anterior to the cord).
Developmental Anatomy of the Pituitary Fossa
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
The tentorium cerebelli is the main dural sheet that loops around the brain stem and separates the cerebral hemispheres from the cerebellum, forming the floor of the middle cranial fossa. It arises from the anterior clinoid processes and has a U-shaped free border looping posteriorly. The peripheral attachments of the tentorium run from the anterior clinoid process backwards as a ridge of dura mater to the apex of the petrous temple bone. This ridge is at the junction of the roof and the lateral part of the cavernous sinus. From here the attachment runs backwards to the posterior clinoid process, forming the roof of the cavernous sinus, and is continuous with the diaphragmatica sella. The remainder of the peripheral attachment of the tentorium is to the superior surface of the petrous temporal bone in the region of the superior petrosal sinus and to the occipital bone in the region of the transverse sinuses.
Anatomy for neurotrauma
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Anesthesia for Neurotrauma, 2018
Vasudha Singhal, Sarabpreet Singh
The tentorium cerebelli separates the occipital lobes of the cerebral hemispheres from the cerebellum. It is attached anteriorly to the posterior clinoid process of sphenoid, laterally to the petrous temporal bone, and posteriorly to the transverse sulci of the occipital bone. The falx cerebri attaches to the tentorium in the midline, pulling it upwards, giving it a tent-like appearance. The tentorium cerebelli divides the cranial cavity into supratentorial and infratentorial compartments. The free concave anteromedial border forms a U-shaped gap called the tentorial notch, filled by the midbrain and the anterior part of the superior aspect of the cerebellar vermis.
Posterior fossa morphometry in 170 South Asian children and adults with Chiari malformation and its correlation with tonsillar descent
Published in British Journal of Neurosurgery, 2022
Bijesh Ravindran Nair, Vedantam Rajshekhar
Multiple angles have been studied in relation to the posterior fossa and tentorium cerebelli by various authors previously (Table 7). Boogard’s angle was found to be significantly high in our patients, similar to the studies done by Karagöz et al.5 and Dufton et al.3 Boogard’s angle has never been shown to be smaller in patients with CM1 in any of the previous studies. A higher Boogard’s angle also confirms a shallow posterior fossa which is a feature in CM1 patients. The angle of the tentorium cerebelli to the Twining line, connecting dorsum sella to the internal occipital protuberance, was stated to be high by many authors. However, we could not identify any difference in this angle between the patient and control population. Similarly, the angle of the tentorium to the supraocciput was also not found to be significant, though Hwang et al.4 and Milhorat et al.6 found this angle to be significantly high in their patients.
The meningeal branch of the superior cerebellar artery
Published in British Journal of Neurosurgery, 2018
Paul R. Krafft, Shih S. Liu, Pankaj K. Agarwalla, Harry R. Van Loveren
Tayebi Meybodi et al. are the first to name this artery eponymously, but prior to that others have identified and illustrated this vessel in the literature. In 1983, the renowned German anatomist Johannes Lang described small arterial branches originating from the SCA that go to and supply the tentorium cerebelli.4 He separately mentions the tentorial artery of the PCA (ADS) described by Wollschlaeger and Wollschlaeger. In 1984, Ono et al. reported the presence of the tentorial branch of the SCA in 28% of 25 dissected cadaver heads.5 Furthermore, Umeoka et al. identified this artery intraoperatively in 15 of 58 patients (25.9%) undergoing microvascular decompression for trigeminal neuralgia.6 Its diameter was reported less than 1 mm in 12 of the 15 patients (80%).6 In 2015, Bhogal et al. demonstrated this artery in their discussion of pio-dural arterial connections.7 We believe that Lang, Ono, Umeoka, Bhogal and Tayebi Meybodi have investigated the same meningeal branch of the SCA that pierces the inferior surface of the tentorium cerebelli posterior to the entry point of the trochlear nerve.1,4–7
Saved by the Pupillometer! – A role for pupillometry in the acute assessment of patients with traumatic brain injuries?
Published in Brain Injury, 2018
John A. Emelifeonwu, Kirsten Reid, Jonathan KJ Rhodes, Lynn Myles
In the acute phases of TBIs, elevations in ICP can result in inter-compartmental herniation of brain. If the area of neuronal injury is supratentorial, then this can lead to herniation of the medial temporal lobe and uncus through the tentorial incisura – the anterior opening between the free edge of the tentorium cerebelli and the clivus, which permits passage of the brainstem. Thus, the brainstem can become compromised. The anatomical proximity of the third cranial nerve to the medial temporal lobe renders it susceptible to compromise also (Figure 1), and the superficially located parasympathetic fibres, which constrict the pupils, are particularly vulnerable. Herniation of the temporal uncus through the incisura therefore compresses the third nerve and the parasympathetic fibres. It is this anatomy of the third nerve that is exploited by clinicians when assessing pupillary response in the context of TBIs; pupillary dilatation and/or non-reactivity suggest third nerve compromise and should prompt appropriate rescue therapeutic measures. The third nerve nucleus in the midbrain can also be affected in cases of brain stem death.