Surgical approaches to the atrium of the lateral ventricle: microsurgical anatomy.
BACKGROUND
Managing lesions situated in the atrium of the lateral ventricle remains a challenging neurosurgical problem. The purposes of this study were to examine the microsurgical anatomy of the atrium of the lateral ventricle and the optic radiation and to define the differences in the exposure obtained by various surgical approaches.


METHODS
Fifteen adult cadaveric specimens were studied using magnification x3 to x40 after perfusion of the arteries and veins with colored silicone. The microsurgical anatomy of the atrium of the lateral ventricle was examined. The relationship between the optic radiation and the atrium was studied using the white matter fiber dissection technique. Surgical approaches to the atrium of the lateral ventricle were examined in stepwise dissection.


RESULTS
The medial and inferior walls of the atrium were free from optic radiation fibers. Surgical approaches to the atrium of the lateral ventricle are divided into 3 routes: (1) anterior approach: transsylvian approach, (2) posterior approaches: posterior transcortical, posterior transcallosal, occipital, and supracerebellar transtentorial approaches, and (3) lateral approaches: transtemporal and subtemporal approaches.


CONCLUSIONS
Knowledge of the microsurgical anatomy of the atrium of the lateral ventricle and surrounding vital structures and the choice of an appropriate surgical approach will help surgeons perform safe and minimally invasive surgery.
Kawashima
Masatou
M
Department of Neurological Surgery, University of Florida, Gainesville, FL 32610-0265, USA. MasatouAzu@aol.com
Li
Xiaoyong
X
Rhoton
Albert L
AL
Ulm
Arthur J
AJ
Oka
Hidehiro
H
Fujii
Kiyotaka
K
D000328:Adult; D002102:Cadaver; D002535:Cerebral Aqueduct / Q000601:surgery; D002540:Cerebral Cortex / Q000601:surgery; D003337:Corpus Callosum / Q000601:surgery; D006801:Humans; D020547:Lateral Ventricles / Q000098:blood supply* / Q000601:surgery*; D008866:Microsurgery; D019635:Neurosurgical Procedures / Q000379:methods*; D009778:Occipital Lobe / Q000601:surgery; D013702:Temporal Lobe / Q000601:surgery