Cerebellar Anatomy as Applied to Cerebellar Microsurgical Resections Jaime Alejandro Ramos MD

Introduction Results References Alejandro Ramos; Feres Chaddad- The majority of dentate nucleus and 7. Mussi A, Rhoton AL Jr. Telovelar approach to Neto;Evandro de Oliveira; Diego González; cerebellar peduncles had demonstrated the fourth ventricle: microsurgical antomy. J Hugo Doria. constant relationship to other cerebellar Neurosurg 2000;92:812-823. 8. Rhoton Al Jr. Microsurgical anatomy of In this article, we have presented the structures, which provided landmarks for posterior fossa cranial nerves. In: Barrow DL microsurgical anatomy of the suboccipital surgical approaching. The lateral border is (Ed). Surgery of the cranial nerves of the and supracerebellar approaches to the separated from the midline by 19.5 mm in posterior fossa. Neurosurgical topics. Chicago: cerebellar surfaces using comprehensives both hemispheres. The posterior border of AANS; 1993: 1-103. anatomic and functional relations with the the cortex is separated 23.3 mm from the 9. Youmans JR. Neurological surgery. final objective of performing better posterior segment of the dentate nucleus; Philadelphia: WB Saunders; 1996. operations with less damage to the the lateral one is separated 26 mm from 10. Yasargyl MG. Microneurosurgery Sttugart: cerebellar nucli and important deep the lateral border of the nucleus; and the Gerog Thieme Verlag; 1984. 11. Matsushina T, Fukui M, Inoue T, Natori Y, pathways. We define the anatomy of posterior segment of the dentate nucleus Baba T, Fujii K. Microsurgical and magnetic dentate nucleus and cerebellar peduncles, is separated 25.4 mm from the resonancia imagen anatomy of the demonstrating the surgical application of posterolateral angle formed by the cerebellomedulary fissure and its application anatomic landmarks in cerebellar junction of lateral and posterior borders of during fourth ventricle surgery. Neurosurgery resections cerebellar hemisphere. 1992;30:325-330. 12. Holmes G. The croonian lectures on the clinical symptoms of cerebellar disease and their Methods Conclusions interpretation. Lancet 1992;2:59-65,111-115. The dentate nucleus, cerebellar peduncles and In conclusion, the thorough knowledge of their relationship with others cerebellar cerebellum anatomy has a tremendous 13. Yasargyl MG. Microneurosurgery: CNS structures were studied in 20 adult cerebellar neurosurgical importance. When dealing tumors-surgical anatomy, neurophatology, hemispheres, 12 male and 8 female corpses, with the cerebellum, it is judicious to neuroradiology, neurophisiology, clinical obtained from São Paulo death verification devise in advance a comprehensive plan of considerations, operability, treatment options. service using X3 to X40 magnifications. Stuttgart: Georg Thieme; 1994. Learning Objectives surgical approach where Navigation To define the anatomy of dentate nucleus and become just a simple tool and not the cerebellar peduncles, demonstrating the surgical main instrument in the surgical procedure. application of anatomic landmarks in cerebellar resections. References Results 1. Carpenter MB. Core text of Neuroanatomy. The dentate nucleus has a unique shape. It is Baltimore: Williams & Wilkins; 1991. oriented in craniocaudal direction and from 2. Rhoton AL Jr. Cerebellum and Fourth lateral to medial. It is helpful to consider the ventricle. Neurosurgery 2000;47(Suppl):S7- dentate nucleus with upper and lower surfaces, S27. and three segments. The upper surface is 3. Lang J. Clinical anatomy of the posterior related medially to the superior cerebellar cranial fossa and its foramina. New York: peduncle and faces the vermis at the junction of Stuttgart, Georg Thieme; 1991. the cumen and declive. The upper surface is 4. Machado A. Neuroanatomia Funcional. bordered laterally, anteriorly, and posteriorly by Estrutura e funções do cerebelo. São Paulo: the fibers of the middle cerebellar peduncle. At Atheneu; 1981, p. 179-186. the basal surface, the dentate nucleus is related 5. Brazis PW, Masdeu J, Biller J. Localization in anteriorly to the caudal segment of the Clinical Neurology. New York: Little, Brown; flocculus, medially to the telovelotonsillar cleft 1996. p. 365-379. and posteromedially to the superior pole of the 6. Rhoton AL Jr. The Posterior Fossa Veins. tonsil and the lateral border of the uvula in its Neurosurgery 2000;47(Suppl):S69-S92. posterolateral third .