Microsurgical anatomy of the foramen of Luschka in the cerebellopontine angle, and its vascular supply

Abstract

Cerebellopontine angle and vascular supply of adjacent brainstem and cerebellum are susceptible to compression and eventual damage by tumors. Delicate and complicated neurosurgical operations in the cerebellopontine angles of the brainstem, where lateral recesses of fourth ventricle empty, are abundant especially operations in which foramina of Luschka are used as possible access to the floor of the fourth ventricle. So awareness and knowledge of the normal anatomical features of the region is valuable for neurosurgeons. Arteries of 40 human cerebella were injected with colored gelatin to investigate the microsurgical anatomy around the foramen of Luschka in the cerebellopontine angle. Two compartments of the foramen of Luschka were distinguished, choroidal part and the patent part. Seventy-four (92.5%) of foramina were open and only 6 (7.5%) foramina were closed. The mean distance between the foramen of Luschka and the anterior inferior cerebellar artery was 3.90 mm on the left side and 3.89 on the right side. The distance from the posterior inferior cerebellar artery was 7.08 and 5.81 mm to the left and right foramina of Luschka, respectively. In ten cases, tortuous vertebral artery was occupying the left cerebellopontine angle space and the foramen of Luschka.

Clinicopathologic study of endolymphatic sac tumor (ELST) and differential diagnosis of papillary tumors located at the cerebellopontine angle

“…This result is consistent with the report by Nevoux that the feeding vessels often arise from branches of the external carotid artery (the posterior auricular artery) or ascending pharyngeal artery and sometimes from branches of the vertebral artery (the anterior inferior cerebellar artery). This finding can help us to distinguish ELST from CPP at the CPA region, the blood supply of which comes from the anterior inferior cerebellar artery …”

“…This finding can help us to distinguish ELST from CPP at the CPA region, the blood supply of which comes from the anterior inferior cerebellar artery. 20,21 ELST arises in the epithelium of the endolymphatic sac ( Fig. 2E1)/duct which is the normal structure of the inner ear, goes through the bone suture and is surrounded by the dura mater.…”

The morphologic analysis of a not well-known anatomical structure’s calcifications (Bochdalek’s flower basket calcifications)

“…However, according to our study especially in elderly patients, Boc FBCs extend to 2 cm far from the center. This different result shows that tortious basilar and vertebral artery calcifications can overlap with Boc FBCs in the cerebellopontine angle [15]. Bradac et al found symmetry between two sides of the choroid plexuses of the fourth ventricle in 96.5% of 57 brain dissections [16].…”

The functional anatomy of the foramina of Luschka revisited

“…is description was ratified by Sharifi et al 6 years later. [7,14] Choroidal compartment of FOL e choroid plexus of the fourth ventricle has T-shaped distribution. Its lateral horizontal section sits laterally in the lateral recess and protrudes outside the FOL, the so-called Bochdalek's flower basket (BFB) [Figure 2].…”