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EN
Rules of geometry and stereomorphometry are often applied to narrow and deep neurosurgical approaches. Methods of research are based on the direct cadaver measurements, radiological analysis and intraoperative measurements. Newly developed devices allow direct morphometry to be performed in vivo, during the operation. We describe the use of the neuronavigation system Stealth Station by Medtronic for such stereomorphometric measurements and evaluate the precision of the described method.
EN
Neurosurgical procedures in the region of the petroclival region of the skull base require unique knowledge of the local anatomy. The measurements of this region considering the visible anatomical landmarks are helpful both during surgery and while planning the general schemes for the approach. We have evaluated the anatomy of the anterior surface of the petrous bone and of the middle fossa taking into consideration the surgical removal of part of the petrous bone — the anterior petrosectomy. We have measured the distances and angles between the chosen structures in this region. The measurements were taken on 10 skulls, on both sides. The results enrich the algorithm of the anterior petrosectomy.
EN
The aim of our study was to describe anatomical variability of the root entry zone (REZ), also called the Ohersteiner--Redlich zone, that represents the "junction zone" of glia and Schwann sheath of the cranial nerves. This zone has some clinical implications. The pulsatile compression of REZ by a vessel may produce clinical symptoms, such us trigeminal neuralgia, hemifacial spasm, glossopharyngeal neuralgia torticollis spasmodicus or even symptoms of essential hypertension when a vascular crross compression of REZ of a left vagus nerve is present. The vessel - cranial nerve contact in the skull base cysterns may be visualized in radiologic examinations, most accurately in magnetic resonance imaging. Because, we cannot distinguish the REZ from the rest of the vagus nerve in radiologic examinations we decided to measure the lenght of its REZ. The microanatomical study of the lenght of REZ zone of the vagus nerve was performed on 2l nerves taken from 17 human brain stems (12 men, 5 women, 14 left, 7 right), fixed with 8% buffered, formalin solution. Paraffin embedded tissue was cut into 1O-um-thick sections pararellel to the nerve longitudinal axis and stained with hematoxilin & eosin. Each of the nerves showed the presence of a zone of oligodendrocyte myelination, mean lenght 2 ą 0.3 mm. In 17 nerves the transitional zone formred a cone-like process, in 4 nerves was shaped irregularly. The length of REZ (oligodendrocyte myelination plus "glial dome") had the mean length 3.5 ą 0,9 mm.
EN
Background: The aim of this study was to investigate the morphometry of the posterior communicating artery (PCoA), on the basis of angio-computed tomography (CT), and to give proof of the mathematical definition of the term “hypoplasia of the PCoA“. Materials and methods: One hundred 3-dimensional (3D) angio-CT images, performed in adult patients with bilateral reconstruction of the PCoA (200 results) were used to calculate the morphometry of the vessel. Results: The average length of the vessel on the right side was 14.48 ± 3.47 mm, and on the left side 14.98 ± 4.77 mm (in women 14.75 mm, in men 14.70 mm). The mean of the diameter at the “proximal” point (the junction with P1) on the right side was 1.49 ± 0.51 mm, and on the left 1.46 ± 0.47 mm (in women 1.44 mm and in men 1.51 mm). The mean of the diameter in the “distal” part (the connection with ICA) on the right side was 1.4 ± 0.49 mm, and on the left 1.37 ± 0.41 mm (in women 1.38 mm, and in men 1.39 mm). No statistical correlation between the length and the diameter of the PCoA in relation to the sex and side was shown. On the basis of our measurements, we defined the hypoplasia of the artery as the estimated value less than the average diameter minus the standard deviation. The percentage distribution was as follows: the left artery 15.5%, the right artery 24%, women 11.5%, and the men 9%. Similarly to the above parameters, we have not found any statistical differences. The presence of the foetal origin was noted in 25% of the radiological examinations. The infundibular widening was visualised in 11.5% of cases of 3D reconstructions. The agenesis of PCoA was found in 9% (never bilaterally), and in 1 case the unilateral duplication of the artery was observed. No statistical differences between those parameters in relation to sex and the examined side were revealed. Conclusions: Morphological calculation of the PCoA on the basis of angio-CT from adult patients did not show any statistical differences depending on sex or the investigated side. The presented method of the calculations proved to be useful for the mathematical definition of the term “hypoplasia of the PCoA”. (Folia Morphol 2014; 73, 3: 286–291)
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