An Eyebrow, Supracarotid Triangle Approach for Lesions at the Ventral Thalamopeduncular Junction: A Technical Report

Briggs, Robert G.; Conner, Andrew K.; Chakraborty, Arijit; Allan, Parker G.; Young, Isabella M.; Teo, Charles; Sughrue, Michael E.

doi:10.1016/j.wneu.2020.04.048

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…Moreover, during an anterior clinoidectomy, an unexpected supraclinoid A1 segment of the ACA could be accidentally damaged. The ventral thalamopeduncular junction, the anteroinferior basal ganglia and the ICA bifurcation could be accessed via the supracarotid triangle [ 39 , 40 ]. The supracarotid triangle is a flat triangle in the supracarotid space, between the initial segment of the A1 ACA, medially, and of the M1 segment of the MCA; the upper base of this triangle is the basomedial frontal lobe (the medial orbital gyrus, lateral to the gyrus rectus and olfactory tract) overlying those arterial segments [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

“…Posterior to the medial orbital gyrus are the anterior olfactory stria and the anterior perforated substance that comprises the inferior aspect of the basal ganglia [ 41 ]. A dissection of this supracarotid triangle involves opening the space around the A1 segment of the ACA until the A1 and M1 segments have been completely mobilized and the bifurcation of the supraclinoid ICA is observed [ 40 ]. Surgeons should be aware that, in cases with an elongated ICA and a supracarotid course of a distal infraoptic A1 segment of the ACA, the supracarotid triangle is likely to be displaced posteriorly, and the inferior medial limit would be represented by the A1 segment coursing over the ICA and continuing medially beneath the optic nerve.…”

Section: Discussionmentioning

confidence: 99%

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The Infraoptic or Infrachiasmatic Course of the Anterior Cerebral Artery Emerging an Elongated Internal Carotid Artery

et al. 2022

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(1) Background: The normal A1 segment of the anterior cerebral artery (ACA) has a supraoptic course. The proximal infraoptic course of an A1 segment leaving the internal carotid artery (ICA) near the origin of the ophthalmic artery is a rare possibility. This study aimed to determine the prevalence and detailed anatomy of infraoptic A1 segments. (2) Methods: We retrospectively studied 145 computed tomography angiograms from 92 male and 53 female cases, with ages varying from 61 to 78 y.o. (3) Results: In 21/145 cases, infraoptic or infrachiasmatic horizontal-medial courses of A1 segments that emerged distally from the ICA were found. Distal infraoptic A1 segments were bilateral in 16/145 cases and unilateral in 3/145 cases. Infrachiasmatic A1 segments were found bilaterally in 2/145 male cases. All the infraoptic/infrachiasmatic A1 segments left long ICAs with low bifurcations. In 7/34 sides with distal infraoptic or infrachiasmatic A1 segments, supracarotid courses were present. In one female, the right A1 segment had an anterior supraclinoid, supracarotid and infraoptic course. In two female cases with a bilateral distal infraoptic A1, the segment was almost contacting the respective posterior cerebral artery. (4) Conclusions: In cases with dolicho(ectatic) ICAs, the A1 segments could have infraoptic and supracarotid courses the neurosurgeons should be aware of.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Infraoptic or Infrachiasmatic Course of the Anterior Cerebral Artery Emerging an Elongated Internal Carotid Artery

et al. 2022

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Supraorbital Versus Transorbital Keyhole Approaches: Selecting the Right Approach

Bander,

Rosen,

Carnevale

et al. 2024

Endoscopic Transorbital Surgery of the Orbit, Skull Base and Brain

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Modified Transanterior Perforated Substance Approach Using the Medial Territory to Thalamomesencephalic Cavernous Malformations: A Case Report

Ni,

Wang,

Zhang

et al. 2023

Neurosurgery Practice

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BACKGROUND AND IMPORTANCE: Thalamomesencephalic lesions remain a challenge to neurosurgeons for their eloquent anatomy and postoperative neurological deficits. With limited cases in the literature, these lesions are still managed in a case-by-case fashion. CLINICAL PRESENTATION: Here, we present a case of an otherwise healthy man who had a 46-day history of impaired vision and right-sided weakness and numbness caused by ventrally located thalamomesencephalic cavernous malformations (CMs). A modified transanterior perforated substance approach using the medial territory was performed for gross total resection of the CMs. No new-onset neurological deficits were observed postoperatively. Apart from visual improvements, the patient's muscle strength constantly improved and recovered full strength on 14-month follow-up. CONCLUSION: The authors believe that the transanterior perforated substance approach through the medial territory can be considered as an option for ventrally located thalamomesencephalic CMs.

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An Eyebrow, Supracarotid Triangle Approach for Lesions at the Ventral Thalamopeduncular Junction: A Technical Report

Cited by 3 publications

References 17 publications

The Infraoptic or Infrachiasmatic Course of the Anterior Cerebral Artery Emerging an Elongated Internal Carotid Artery

The Infraoptic or Infrachiasmatic Course of the Anterior Cerebral Artery Emerging an Elongated Internal Carotid Artery

Supraorbital Versus Transorbital Keyhole Approaches: Selecting the Right Approach

Modified Transanterior Perforated Substance Approach Using the Medial Territory to Thalamomesencephalic Cavernous Malformations: A Case Report

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