Albert L Jr Rhoton

Microsurgical anatomy for lateral approaches to the foramen magnum, especially for transcondylar fossa (supracondylar transjugular tubercle) approach, was studied using cadavers. The transcondylar fossa approach is an approach in which extradural removal of the posterior portion of the jugular tubercle through the condylar fossa is added to the far lateral approach. Some differences between this approach and the transcondylar approach are demonstrated. The atlanto-occipital joint and the ...

The microsurgical anatomy of the supraclinoid portion of the internal carotid artery (ICA) was studied in 50 adult cadaver cerebral hemispheres using X 3 to X 40 magnification. The ICA was divided into four parts: the C1 or cervical portion; the C2 or petrous portion; the C3 or cavernous portion; and the C4 or supraclinoid portion. The C4 portion was divided into three segments based on the origin of its major branches: the ophthalmic segment extended from the origin of the ophthalmic ...

OBJECTIVE: To describe the exposure obtained through six approaches to the perimesencephalic cisterns with an emphasis on exposure of the posterior cerebral artery and its branches.

METHODS: Dissections in 12 hemispheres exposed the crural, ambient, and quadrigeminal cisterns and related segments of the posterior cerebral artery. A Stealth Image Guidance workstation (Medtronic Surgical Navigation Technologies, Louisville, CO) was used to compare the approaches.

RESULTS: The transsylvian ...

OBJECTIVE: To examine the relationship of the clinoid segment of the internal carotid artery to the structures in the roof of the cavernous sinus and to determine whether this segment is neither intradural nor intracavernous, as recently proposed.

METHODS: The region of the roof of the cavernous sinus was dissected and examined using 3 to 40x magnification and micro-operative techniques.

RESULTS: The clinoid segment was located within a collar formed by the dura lining the medial surface ...

OBJECTIVE: Tumors within Meckel's cave are challenging and often require complex approaches. In this report, an expanded endoscopic endonasal approach is reported as a substitute for or complement to other surgical options for the treatment of various tumors within this region.

METHODS: A database of more than 900 patients who underwent the expanded endoscopic endonasal approach at the University of Pittsburgh Medical Center from 1998 to March of 2008 were reviewed. From these, only ...

BACKGROUND: The cerebellar hemorrhage reported in numerous cases after supratentorial craniotomy has uniformly exhibited the characteristics of hemorrhage associated with venous infarction rather than arterial bleeding. The cause has remained obscure, although previous reports suggested that the cause may be obstruction of flow in the internal jugular vein immediately below the base of the skull.

METHODS: The microsurgical anatomy of 36 internal jugular veins in the upper cervical region ...

OBJECTIVE: To describe the surgical anatomy of the anterior, middle, and posterior portions of the medial temporal region and to present an anatomic-based classification of the approaches to this area.

METHODS: Twenty formalin-fixed, adult cadaveric specimens were studied. Ten brains provided measurements to compare different surgical strategies. Approaches were demonstrated using 10 silicon-injected cadaveric heads. Surgical cases were used to illustrate the results by the different ...

OBJECTIVE: In the transsylvian approach to the mediobasal temporal structures, the temporal horn is approached through the floor of the sylvian fissure. The anterior bundle of the optic radiations (Meyer's loop) courses between the floor of the sylvian fissure and roof of the temporal horn and could be damaged in this approach. This study was designed to define the route through the floor of the sylvian fissure least likely to damage the optic pathways.

METHODS: Meyer's loop was ...

✓ The microsurgical anatomy of the arteries supplying the choroid plexus of the lateral and third ventricles was examined in 50 formalin-fixed cerebral hemispheres using × 3 to × 20 magnification. There was marked variation in the area of choroid plexus supplied by the choroidal arteries; however, the most common pattern was for the anterior choroidal artery (AChA) to supply a portion of the choroid plexus in the inferior horn and part of the atrium; the lateral posterior choroidal ...

OBJECTIVE: This study was conducted to clarify the boundaries, relationships, and components of the medial wall of the cavernous sinus (CS).

METHODS: Forty CSs, examined under x3 to x40 magnification, were dissected from lateral to medial in a stepwise fashion to expose the medial wall. Four CSs were dissected starting from the midline to lateral.

RESULTS: The medial wall of the CS has two parts: sellar and sphenoidal. The sellar part is a thin sheet that separates the pituitary fossa ...

The microvascular anatomy of the posterior part of the circle of Willis, important in surgery of pituitary tumors and basilar aneurysms, was defined in 50 cadaver brains. Significant findings were as follows: 1) Anomalies of the posterior half of the circle of Willis were found in 46% of cases. 2) Hypoplastic P-1 (posterior cerebral segment) and posterior communicating segments gave origin to the same number and size of perforating arteries, having the same termination as normal-sized ...

OBJECTIVE: We review the anatomic features of the lateral ventricle, the foramen of Monro, the third ventricle, and the choroidal fissure, and we describe the transchoroidal approach to the third ventricle. This approach consists of opening the taenia fornicis of the choroidal fissure in the body of the lateral ventricle and approaching the third ventricle between the two internal cerebral veins. This route allows further posterior enlargement of the foramen of Monro without sacrificing ...

OBJECT: The two most common surgical routes to the fourth ventricle are the transvermian and telovelar approaches. The purpose of this study was to compare the microanatomy and exposures gained through these approaches.

METHODS: Ten formalin-fixed specimens were dissected in a stepwise manner to simulate the transvermian and telovelar surgical approaches. Stealth image guidance was used to compare the exposures and working angles obtained using these approaches. The transvermian and ...

Fifty cavernous sinuses from cadavers were studied in detail using magnification, with special attention to the relationships important in surgical approaches on the intracavernous structures, and to understanding arterial contributions to arteriovenous fistulas involving the cavernous sinus. Significant findings were: 1) The three main branches of the intracavernous portion of the carotid artery were the meningohypopyseal artery, present in 100% of the specimens, the artery of the ...

OBJECT: The purpose of this study was to define the topographic anatomy, arterial supply, and venous drainage of the insula and sylvian fissure.

METHODS: The neural, arterial, and venous anatomy of the insula and sylvian fissure were examined in 43 cerebral hemispheres.

CONCLUSIONS: The majority of gyri and sulci of the frontoparietal and temporal opercula had a constant relationship to the insular gyri and sulci and provided landmarks for approaching different parts of the insula. The ...