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

  • Peter Kurucz EMAIL logo , Gábor Baksa , Lajos Patonay , Firas Thaher and Nikolai J. Hopf
Published/Copyright: December 2, 2014
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Abstract

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 endoscope-controlled 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.


Corresponding author: Peter Kurucz, MD, Department of Neurosurgery, Katharinenhospital, Klinikum Stuttgart, Kriegsbergstrasse 60, 70174 Stuttgart, Germany, Tel.: +49 1522 699 1301, Fax: +49 711 278 33709, E-mail: ; and Laboratory for Applied and Clinical Anatomy, Institute of Anatomy, Histology and Embryology, Faculty of Medicine, Semmelweis University, Budapest, Hungary

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2014-6-23
Accepted: 2014-11-3
Published Online: 2014-12-2
Published in Print: 2014-12-1

©2014 by De Gruyter

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