Endoscopic anatomical study of the arachnoid architecture on the base of the skull. Part II: Level of the tentorium, posterior fossa and the craniovertebral junction

Kurucz, Peter; Patonay, Lajos; Hopf, Nikolai J.

doi:10.1515/ins-2013-0008

Cited by 9 publications

(14 citation statements)

References 9 publications

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“…In our previous series of publications that addressed the anatomy of the entire arachnoid membrane system on the base of the skull, (Kurucz et al, , ), we also verified the existence of this rhomboid‐shaped structure. Endoscopic photomicrographs as well as schematic drawings were presented, but a detailed morphometric analysis and histological examinations were not performed.…”

Section: Discussionsupporting

confidence: 78%

The “Valva Cerebri”: Morphometry, Topographic Anatomy and Histology of the Rhomboid Membrane at the Craniocervical Junction

et al. 2019

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The arachnoid membranes' anatomy is a controversial topic in the literature, and the rhomboid membrane at the craniovertebral junction is an element of this system that has been described poorly. Hence, the objective of our study was to examine this membrane's anatomy and histology. A total of 45 fresh formalin‐fixed human cadaveric heads were examined, and anatomic dissections and histologic examinations using standard staining methods were performed. The membrane was found to be a constant structure. It has a rhomboid shape and is located on the medulla oblongata and upper cervical spine's ventral surface within the subarachnoid space. Its average craniocaudal length is 49 mm and the short axis is 26 mm. The cranial apex is attached to the vertebral arteries' junction, and the caudal apex reaches the level of C4. The lateral apices are attached to the dura mater at the level of the denticulate ligament's second insertion. The C1 spinal nerves perforate the membrane, while the C2 roots are located dorsal to it. The membrane is attached strongly to the underlying pia mater. Histologically, it has a typical arachnoid structure, in which its adhesions to the vertebral arteries as well as to the pia mater could be verified histologically. This is the first detailed examination of the rhomboid membrane. Our results suggest that the membrane serves a valve‐like function between the spinal and cranial subarachnoid spaces. Based on our findings, further hydrodynamic studies should clarify the membrane's physiological role. Clin. Anat. 32:56–65, 2019. © 2019 Wiley Periodicals, Inc.

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Section: Discussionsupporting

confidence: 78%

The “Valva Cerebri”: Morphometry, Topographic Anatomy and Histology of the Rhomboid Membrane at the Craniocervical Junction

et al. 2019

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“…Because the entire portion of the nerve is located in the interpeduncalar fossa, we like to refer to it as the interpeduncular segment. The membranes belong to the tentorial membrane group [8]: the posterior cerebral membranes and the posterior portion of the lateral mesencephalic membranes. This part of the oculomotor nerve is encased by complete inner arachnoid sheaths.…”

Section: Interpeduncular Segmentmentioning

confidence: 99%

“…The here located part of the arachnoid membrane system is called tentorial membrane group [8]. Therefore, we propose to refer to this portion of the nerve as to the tentorial segment.…”

Section: Tentorial Segmentmentioning

confidence: 99%

“…We refer in particular to our own published series in two parts on the anatomy of the arachnoid membrane system of the entire skull base [7,8]. As a consequence of this more detailed anatomical knowledge, a finer description of the intracisternal portion of surgically relevant neurovascular structures becomes necessary.…”

Section: Introductionmentioning

confidence: 99%

“…The oculomotor nerve is located at the junction of three previously described arachnoid membrane groups [7,8]. These are the carotid, the tentorial, and the clival membrane groups.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic anatomy of the intracisternal oculomotor nerve: a new segmentation based on the topography of the arachnoid membranes

Kurucz¹,

Patonay

Thaher

et al. 2014

Innovative Neurosurgery

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Objective: The aim of our study was to investigate the detailed endoscopic anatomy of the intracisternal portion of the oculomotor nerve and to update the present knowledge of its related anatomy with the newest research on the topography of the arachnoid membrane system of the skull base. Methods: This study was performed on 50 fresh human cadaveric specimens post-mortem not more than 72 h. In each specimen, the intracranial arterial system was injected with red gelatin solution. We used the endoscopecontrolled and endoscope-assisted microsurgical techniques applied through the minimally invasive supraorbital keyhole craniotomy to perform our dissections. Results: We divided the intracisternal oculomotor nerve into three segments in this study. These are the interpeduncular segment, located in the interpeduncular fossa and surrounded by dens arachnoid trabeculae around the thalamoperforating arteries; the tentorial segment, located between the posterior cerebral and superior cerebellar arteries and the posterior petroclinoid fold and surrounded by the elements of the clival and tentorial arachnoid membrane groups; and the trigonal segment located on the surface of the oculomotor trigone between the posterior petroclinoid fold and the dural exit of the nerve into the cavernous sinus and surrounded by the posteriorly located membranes of the carotid membrane group. Conclusions: Our findings support the more accurate understanding of the physiology of the arachnoid membrane system and the pathophysiology of space-occupying lesions in the region of the oculomotor nerve. Therefore, our results may support performing more atraumatic surgery in this area.

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Anatomical correlates for the newly discovered meningeal layer in the existing literature: A systematic review

Kumar,

Narayan

et al. 2024

The Anatomical Record

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The existence of a previously unrecognized subarachnoid lymphatic‐like membrane (SLYM) was reported in a recent study. SLYM is described as an intermediate leptomeningeal layer between the arachnoid and pia mater in mouse and human brains, which divides the subarachnoid space (SAS) into two functional compartments. Being a macroscopic structure, having missed detection in previous studies is surprising. We systematically reviewed the published reports in animals and humans to explore whether prior descriptions of this meningeal layer were reported in some way. A comprehensive search was conducted in PubMed/Medline, EMBASE, Google Scholar, Science Direct, and Web of Science databases using combinations of MeSH terms and keywords with Boolean operators from inception until 31 December 2023. We found at least eight studies that provided structural evidence of an intermediate leptomeningeal layer in the brain or spinal cord. However, unequivocal descriptions for this layer all along the central nervous system were scarce. Obscure names like the epipial, intermediate meningeal, outer pial layers, or intermediate lamella were used to describe it. Its microscopic/ultrastructural details closely resemble the recently reported SLYM. We further examined the counterarguments in current literature that are skeptical of the existence of this layer. The potential physiological and clinical implications of this new meningeal layer are significant, underscoring the urgent need for further exploration of its structural and functional details.

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Endoscopic anatomical study of the arachnoid architecture on the base of the skull. Part II: Level of the tentorium, posterior fossa and the craniovertebral junction

Cited by 9 publications

References 9 publications

The “Valva Cerebri”: Morphometry, Topographic Anatomy and Histology of the Rhomboid Membrane at the Craniocervical Junction

The “Valva Cerebri”: Morphometry, Topographic Anatomy and Histology of the Rhomboid Membrane at the Craniocervical Junction

Endoscopic anatomy of the intracisternal oculomotor nerve: a new segmentation based on the topography of the arachnoid membranes

Anatomical correlates for the newly discovered meningeal layer in the existing literature: A systematic review

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