Rethinking the standard trans-cortical approaches in the light of superficial white matter anatomy

来源 :Neural Regeneration Research | 被引量 : 0次 | 上传用户:woyaopojiemimaya
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A better comprehension of the superficial white matter organization is important in order to minimize potential and avoidable damage to long or intermediate association fibre bundles during every step of a surgical approach.We recently proposed a technique for cadaver specimen preparation,which seems able to identify a more systematic organization of the superficial white matter terminations.Moreover,the use of the physiological intracranial vascular network for the fixation process allowed us to constantly show main vascular landmarks associated with white matter structures.Hence three examples of standard approaches to eloquent areas are herein reanalyzed starting from the first superficial layer.New insights into the possible surgical trajectories and subsequent quantitative damages of both vessels and white matter fibres can help readapt even the most standard and widely accepted approach trough the brain cortex.A more detailed study of these fine anatomical details may become in the near future a fundamental part of the neurosurgical training and the preoperative planning. A better comprehension of the superficial white matter organization is important in order to minimize potential and avoidable damage to long or intermediate association fiber bundles during every step of a surgical approach. We recently proposed a technique for cadaver specimen preparation, which seems able to identify a more systematic organization of the superficial white matter terminations. Moreover, the use of the physiological intracranial vascular network for the fixation process allowed us to constantly show the main vascular landmarks associated with white matter structures. There are three examples of standard approaches to eloquent areas are herein reanalyzed starting from the first superficial layer. New insights into the possible surgical trajectories and subsequent quantitative damages of both vessels and white matter fibers can help readapt even the most standard and widely accepted approach trough the brain cortex. A more detailed study of these fine anatomical details may become in t he near future a fundamental part of the neurosurgical training and the preoperative planning.
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