Variations in location of the arteries coursing between the brain stem and the free edge of the tentorium

Abstract

The locations of arterial branches crossing the free edge of the tentorium were studied in 16 adult cadavers. Two positional variants of the superior cerebellar artery and four variants of the posterior cerebral artery were identified. The points at risk of compression by different types of transtentorial brain herniation were defined for both the arterial branches supplying the brain stem and the arterial branches supplying the cerebral hemispheres.

Combined internal uncusectomy and decompressive craniectomy for the treatment of severe closed head injury: experience with 80 cases

“…Displacement from one intracranial compartment to another due to sudden brain expansion determines a pressure gradient be- tween different compartments; the mechanism lies in the obliteration of the subarachnoid space and cisterns 18 and subsequent hemorrhagic and ischemic brain damage. 1,4 Rapid expansion of a supratentorial mass lesion causes distortion of the brain and is associated with elevated ICP 1,20 and downward transtentorial herniation, which is a common and clinically significant type of brain herniation. In cases of tentorial herniation, the mesial temporal structures remain trapped in the tentorial incisura and undergo compressive damage; thus, simply evacuating a hematoma with or without osseous decompression may not alleviate brain herniation that has already occurred.…”

“…In cases of tentorial herniation, the mesial temporal structures remain trapped in the tentorial incisura and undergo compressive damage; thus, simply evacuating a hematoma with or without osseous decompression may not alleviate brain herniation that has already occurred. 2,4,29 Until recently, all efforts have been focused on controlling increased ICP by using mainly medical measures. This strategy has certainly helped to improve patient outcomes, although not as much as expected.…”

Neuropsychology and clinical neuroscience of persistent post-concussive syndrome

“…As the tenortium projects to its clinoid-lesser wing of the sphenoid connection, the lateral surface of the upper brainstem touches the "free edge" of the tentorium cerebelli, and just on the other side of the tentorium at this level is the medial surface of the temporal lobe, where the peririhinal and entorhinal surfaces also touch the "free edge" of the tentorium (Bigler, 2007;Van Hoesen et al, 1999). What is also of particular interest with regards to consciousness is that arterial branches of the posterior circulation of the brain actually cross the free edge of the tentorium and these arterial branches supply blood to the brainstem (Blinkov et al, 1992).…”

3T MRI — 3D DSA Fusion Technique on Posterior Cerebral Artery Dissecting Aneurysm: Understanding a Potential Pathophysiologic Mechanism

“…The course of the PCA in relation to the free edge of the tentorium is shown to have four variations 2 . In the medial variant, the main trunk is located medial to the free edge of the tentorium.…”