Craniometrics and Ventricular Access: A Review of Kocher's, Kaufman's, Paine's, Menovksy's, Tubbs’, Keen's, Frazier's, Dandy's, and Sanchez's Points

Morone, Peter J.; Dewan, Michael C.; Zuckerman, Scott L.; Tubbs, R. Shane; Singer, Robert D.

doi:10.1093/ons/opz194

Cited by 59 publications

(65 citation statements)

References 27 publications

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“…However, this proposal was not widely adopted owing to the complexity of the procedures, and the associated damage to the skull base and structures. In this study, we approached the CSF space using a previously reported simple and common external ventricle drain technique (Morone et al 2019), and demonstrated that this procedure could successfully restore brain elasticity. Moreover, this TEIF procedure exhibited a low risk of formaldehyde exposure.…”

Section: Discussionmentioning

confidence: 92%

Thiel’s embalming method with additional intra-cerebral ventricular formalin injection (TEIF) for cadaver training of head and brain surgery

et al. 2020

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Thiel's embalming method provides natural coloration, flexibility, and tissue plasticity, and is used widely to prepare specimens for cadaver surgical training. However, this method causes brain softening, thereby restricting the cadaver surgical training of intra-cranial procedures. In this study, three cadavers were embalmed using formalin fixation, Thiel's embalming method, and Thiel's embalming method with additional intra-cerebral ventricular formalin injection, respectively. We also established rat models of the three embalming methods to develop and determine the best method for retaining adequate brain elasticity. The intra-ventricular formalin injection in the cadaver was performed through the Kocher's point, as in the classical external ventricular drain procedure. Both, the cadaver brains and rat models yielded consistent shear wave measurements and brain surface stiffness data. Notably, the Thiel's embalming method with additional intra-cerebral ventricular formalin injection yielded suitable elasticity for brain cadaver surgical training in terms of brain mobilization and surgical field deployment, and also discharged formaldehyde in undetectable quantities. To our knowledge, this is the first report in which a fixed quality, namely, brain elasticity for the performance of head and brain cadaver surgical training, has been evaluated in a cadaver subjected to the Thiel's embalming method with immersion fixation in the cerebrospinal fluid space. We conclude that the Thiel's embalming method with additional intra-cerebral ventricular formalin injection can maintain the brain elasticity, and may therefore improve the quality of head and brain cadaver surgical training safely and easily.

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Section: Discussionmentioning

confidence: 92%

Thiel’s embalming method with additional intra-cerebral ventricular formalin injection (TEIF) for cadaver training of head and brain surgery

et al. 2020

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“…Kocher's point provides access to the frontal horn of the lateral ventricle. This precoronal point is so located to be lateral to the SSS and always anterior to the primary motor area [13]. Keen's point is located in the posterior parietal surface, 2-3 cm superior and posterior to the ear's pinna.…”

Section: Craniometric Points For Ventricular Accessmentioning

confidence: 94%

“…The catheter is direct cephalic and perpendicular to the temporal cortex (Interactive Model 7). The trigone of the ipsilateral ventricle is located 4-5 cm below [13].…”

Section: Craniometric Points For Ventricular Accessmentioning

confidence: 99%

“…The catheter follows a medial and superior trajectory and is directed to a point placed 4 cm above the contralateral medial canthus. After 5 cm, the occipital horn and the body of the lateral ventricle should be reached [13].…”

Section: Craniometric Points For Ventricular Accessmentioning

confidence: 99%

“…The burr hole is placed 3 cm over the In and 2 cm laterally under the lambdoid suture (Interactive Model 7). The catheter is directed superiorly towards a point 2 cm above the Gl and inserted 4-5 cm to reach the occipital horn and body of the lateral ventricle [13].…”

Section: Craniometric Points For Ventricular Accessmentioning

confidence: 99%

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Immersive Surgical Anatomy of the Craniometric Points

Vigo

Cornejo

Nunez

et al. 2020

Cureus

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Craniometric points (CPs) have been used in neurosciences since the 1800s. Localization of the CPs allows for the identification of crucial intracranial structures. Despite the contribution of advanced technology to surgery, the knowledge of these points remains crucial for surgical planning and intraoperative orientation. The understanding of these crucial points can be facilitated with the use of three-dimensional technology combined with anatomical dissections. The present study is part of a stereoscopic collection of volumetric models (VMs) obtained from cadaveric dissections that depict the relevant anatomy of the CPs. Five embalmed heads and two dry skulls have been used to depict these points. After the anatomical dissection, stereoscopic images and VMs were generated to show the correlation between external and internal landmarks. The CPs identified were divided into sutures, suture junctions, prominences and depressions, and cortical surface landmarks. The VMs represent an interactive way to define these points easily and their correlation with different intracranial structures (vascular structure, ventricle cavity, and Brodmann's areas).

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