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Anatomy for neurotrauma
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Anesthesia for Neurotrauma, 2018
Vasudha Singhal, Sarabpreet Singh
The basal vein (of Rosenthal) is formed by the union of the anterior and deep middle cerebral veins, beneath the anterior perforated substance. It also receives tributaries from the interpeduncular fossa, inferior horn of the lateral ventricle, parahippocampal gyrus, and midbrain.
Anatomical considerations
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Manual of Neuroanesthesia, 2017
Veins draining the cerebral hemisphere consist of superficial and deep veins. Superficial veins drain the cerebral cortex and end in the neighboring venous sinuses, which are superior cerebral veins, inferior cerebral veins, and superficial middle cerebral veins. Deep veins drain the deeper structures (such as the thalamus, hypothalamus, caudate nucleus, putamen, internal capsule, corpus callosum, and choroid plexus) and join to form two internal cerebral veins and two basal veins. These veins drain into the great cerebral vein (great vein of Galen) that ends in the straight sinus. The cerebellum is drained by the superior and inferior cerebellar veins into the straight sinus and other neighboring venous sinuses.1 The veins from the brain stem drain into the adjoining venous sinuses and inferiorly the veins from the medulla are continuous with the veins of the spinal cord.
Intracranial subarachnoid hemorrhage following cervical laminoplasty: a report of two cases
Published in International Journal of Neuroscience, 2018
Yuichi Kondo, Kazunari Fushimi, Makoto Takasawa, Shigeo Kanamori, Takaki Miyagawa, Kenji Kawashima, Kazutoshi Yokoyama, Haruhiko Akiyama
Most patients with spontaneous SAH have blood vessel abnormalities, such as cerebral aneurysm, arterial malformation. However, in about 15% of patients with SAH, no vascular abnormalities are observed on angiography [10,11]. Rinkel et al. showed that angiogram-negative SAH has a more favorable prognosis than angiogram-positive SAH [10]. While the mechanisms underlying non-aneurysmal SAH remain unclear [12], they are more likely to involve venous causes rather than arterial causes. Tearing of the basal vein of Rosenthal or a tributary are possible sources of bleeding that might explain the present cases [12]. In addition, anatomical variants of the basal vein may contribute to the pathogenesis of idiopathic SAH [11]. Canhao et al. reported that hypertension is an important risk factor for idiopathic SAH [13]. In our study, temporary hypertension was observed during surgery in Case 2 and may have been one of the risks for development of SAH.
The supracerebellar infratentorial approach in pineal region tumors: Technique and outcome in an underprivileged setting
Published in Alexandria Journal of Medicine, 2018
Mahmoud Abbassy, Khaled Aref, Ahmed Farhoud, Anwar Hekal
Technique: Elevation of the head of the bed, dehydration using mannitol, CSF drainage from the cisterna magna and occasionally ventricular drainage were used to relax the brain. (Fig. 3) The dura was usually opened in a transverse fashion on each side of the midline, allowing the ligation and cutting of the cerebellar sinus together with the cerebellar falx. After opening the dura, the microscope was introduced. We used a Zeiss® OPMI Vario® S88 microscope in all cases. The cerebellum was then freed from the tent by adequate dissection of the arachnoid and using cottonoids. We tried to preserve bridging veins as much as possible, however, it was necessary to sacrifice some of them over the dorsum of the cerebellum for adequate visualization. The quadrigeminal cistern is usually surrounded by thickened and sometimes opaque arachnoid. It must be opened microsurgically and well dissected to allow adequate exposure of the tumor and to be able to appreciate all the anatomy. The precentral vein was usually seen extending from the vermis to the vein of Galen. Basal veins of Rosenthal were usually seen at the medial aspect of the temporal lobe. Through our experience we refined the approach through paramedian extension of the corridor to allow working around the bridging veins to preserve them. Usually, the most difficult part of the surgery was the dissection of the inferior surface of the tumor, as it may get adherent to the midbrain tectum and difficult to be visualized. If the tumor is benign or well encapsulated, it may be removed completely. Oxidized cellulose in the form of Surgicel® can be put carefully on the raw areas in a fashion that does not allow it to float into the third ventricle, not to obstruct the aqueduct. After surgery was done, dura was closed in a watertight fashion, bone flap is repositioned and fixed using absorbable sutures.