The Microsurgical Anatomical Study of transcerebellomedullary fissure approach / 中国神经精神疾病杂志

ABSTRACT

Objective To study transcerebellomedullary fissure approach to the fourth ventricle and the lateral brainstem without splitting vermis and depict its adjacent structure, and provide clinicians with anatomical information.Methods Five cadaveric heads fixed with formaldehyde and perfused with color latex in their arteries and veins were dissected with microsurgical anatomical skills. The composition of cerebellomedullary fissure and the distribution of the tela choroida, the inferior medullary velum and the posterior inferior cerebellar artery, and study anatomic base of this approach.Results Cerebellomedullary fissure is a natural anatomical gap which is located between the cerebellar tonsil, biventral lobule and medulla oblongata. The tela choroida and inferior medullary velum do not contain nerve tissue, and thus can be dissected to expose the fourth ventricle. The tonsil- medulla segment and telovelotonsillar segment of the posterior inferior cerebellar artery are the most important blood vessels of the cerebellomedullary fissure approach.Conclusions The transcerebellomedullary fissure approach can reach the fourth ventricle and dorsal brain stem through normal anatomic spaces without splitting the vermis, thus reducing the post-operative complications.