Abstract
Purpose
Anatomical knowledge of the floor of the third ventricle (FTV) is essential in avoiding surgical complications during endoscopic third ventriculostomy. The purpose of this study was to characterize the morphometry of FTV and related arteries, particularly the basilar artery (BA), as well as the factors that influence it.
Methods
Twenty-six formalin-fixed adult brains and two hundred adult brain MRIs were studied focusing on FTV and related arteries. Dimensions of interest were measured using image analysis software. Morphometric data obtained were statistically analysed.
Results
Distances between FTV, intermammillary sulcus (IMS), infundibulum, BA bifurcation, and posterior communicating arteries (PCoAs) were described on the cadavers and the MRIs. Distance between right and left PCoAs was greater at their anterior extremity (p < 0.001). Right PCoA was longer (p = 0.016). BA was lateralized in 58.4% of cases and its calibre was larger in males (p < 0.001). The distance from BA apex to FTV was inversely correlated with BA diameter (p < 0.001) and age (p = 0.004). Distance from IMS to infundibulum and the distance between both PCoAs were greater in MRI series when compared to cadaver series (p < 0.001).
Conclusions
A quantitative description of the morphometry of the region of the FTV and related vessels was obtained, hel** neurosurgeons in planning their surgical approach. The distance from BA apex to FTV was shorter in individuals with larger BA calibre and in older subjects. MRI studies were qualitatively superior to cadaveric studies in evaluating the anatomy of this region.
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Acknowledgements
The authors desire to show deep appreciation for the anonymous cadaver donors of Faculty of Medicine of University of Porto, as well as their families. We also thank Professor Dulce Madeira, Director of the Unit of Anatomy of the Department of Biomedicine and responsible for the Body Donation Program, for her permanent support.
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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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J Fernandes-Silva: project development, data collection, data analysis, and manuscript writing and editing. SM Silva: project development, data collection, data analysis, and manuscript writing and editing. H Alves: data analysis and manuscript writing and editing. JP Andrade: data collection, data analysis, and manuscript writing and editing. M Arantes: project development, data collection, data analysis, and manuscript writing and editing.
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Fernandes-Silva, J., Silva, S.M., Alves, H. et al. Neurosurgical anatomy of the floor of the third ventricle and related vascular structures. Surg Radiol Anat 43, 1915–1925 (2021). https://doi.org/10.1007/s00276-021-02785-8
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DOI: https://doi.org/10.1007/s00276-021-02785-8