학술논문

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
Document Type
research-article
Source
Innovative Neurosurgery. 1(2):91-108
Subject
Arachnoid membranes
arachnoid membrane system
endoscopic anatomy: skull base
subarachnoid cisterns
Research Articles
Language
English
ISSN
2193-5238
2193-522X
Abstract
Interest in surgical anatomy of arachnoid membranes is relatively new and became more important with the development of endoscopic techniques in neurosurgery. In the first part we introduced the term “arachnoid membrane system” and “arachnoid membrane groups” and described them in the anterior and middle cranial fossa. The objective of this second part is to discuss the arachnoid membranes of the tentorial level, posterior fossa and the craniovertebral junction. Rigid endoscopes were introduced through defined keyhole craniotomies to explore the arachnoid in 127 fresh human cadavers. We defined 12 inner membranes that are arranged in three membrane groups. The “tentorial membrane group” consists of five paired membranes forming an almost complete barrier between the supra- and infratentorial spaces. The “clival membrane group” consists of three membranes and completes the separation created by the tentorial group. The superior part of the “perimedullary group” located around the medulla oblongata and consists of three inner membranes. The inferior part located in the craniovertebral junction consisting of four membranes. Intracranial arachnoid membranes are constant and defined structures that are well arranged in distinct groups. These new findings are essential in understanding the three-dimensional architecture of the arachnoid and its importance in endoscopic neurosurgery.

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