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Ventricles 360°

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Ventricles 360°

  1. 1. Ventricles 360°. 29-8-2015
  2. 2. For Other powerpoint presentatioins of “ Skull base 360° ” I will update continuosly with date tag at the end as I am getting more & more information click www.skullbase360.in - you have to login to slideshare.net with Facebook account after clicking www.skullbase360.in
  3. 3. Great teachers – All this is their work . I am just the reader of their books . Prof. Paolo castelnuovo Prof. Aldo Stamm Prof. Mario Sanna Prof. Magnan
  4. 4. 3rd ventricle
  5. 5. 3rd ventricle entered through 1. Supra optic chiasmic route – by Lamina terminalis 2. Infra optic chiasmic route – by Tuber cinerereum
  6. 6. Infra optic chiasmic route – by Tuber cinerereum
  7. 7. 3rd ventricle entry through Tuber cinereum is laterally limited by Pcoms Endoscopic third ventricle from posteriorly -- a. Infundibular recess b. tuber cinereum c. mammillary bodies left posterior communicating artery (a), mammillary body (b), and right posterior hypoplasic communicating artery (c) --- measurement performed between the posterior communicating arteries using Geogebra software (a-b = 11.3 mm),
  8. 8. 3rd ventricle entry by - Supra optic chiasmic route – by Lamina terminalis
  9. 9. 3rd ventricle entry through lamina terminalis is laterally limited by A1s & above by Acom Opening the lamina terminalis below the AcomA allows entrance into the anterior part of the third ventricle. A2 usually ascends, in front of the lamina terminalis, to pass into the longitudinal fi ssure between the cerebral hemispheres
  10. 10. Note LAMINA TERMINALIS IN PTERIONAL APPROACH
  11. 11. Optic chiasma – infundibulum – Mamillary bodies
  12. 12. AcomA anterior communicating artery, CP choroid plexus, HT hypothalamus, MB mammillary bodies, MI massa intermedia, OC optic chiasm, PC posterior commissure, T thalamus, ThV fl floor of the third ventricle, white asterisk opening of the Sylvius aqueduct, red arrow front door to the third ventricle The anterior wall of the third ventricle is given by the lamina terminalis. The roof of this ventricle is given by the tela choroidea, which presents paired choroid plexuses.
  13. 13. Lateral ventricle
  14. 14. Analogy Entry of lateral ventricle from 3rd ventricle through Foramen of Monro which is present laterally Entry of maxillary sinus from nose through maxillary osteum which is present laterally
  15. 15. CC corpus callosum, CP choroid plexus, MI massa intermedia, PC posterior commissure, T thalamus, ThV fl floor of the third ventricle, yellow arrow opening of the Silvius aqueduct, red asterisk suprapineal recess, white asterisk ( left ) lateral ventricle, white circles foramen of Monro Lateral ventricles are located in the cerebral hemispheres. They communicate with the third ventricle by the foramen of Monro.
  16. 16. FM – Foramen of Monro
  17. 17. FM – Foramen of Monro
  18. 18. yellow arrow opening of the Silvius aqueduct
  19. 19. 0 degree endoscope. The endoscope is inserted into the third ventricle behind the pituitary stalk and from the left side. The posterior part of the ventricular cavity is explored. - - From Atlas of Endoscopic Anatomy for Endonasal lntracranial Surgery ; Paolo Cappabianca
  20. 20. 00 endoscope. The endoscope is approached closer to the pineal recess.
  21. 21. 30° endoscope. The endoscope is turned to the right side.
  22. 22. 30° endoscope. The endoscope is orientated upwards and approached closer to the pineal recess. Closer view.
  23. 23. Endoscopic Third Ventriculostomy ( ETV) in treatment of Hydrocephalus http://drvksgautam.blogspot.in/2014/01/role-endoscopic-third- ventriculostomy.html Endoscope is passed from right lateral ventricle to third ventricle through Foramen of Monro
  24. 24. Intraoperative Endoscopic view of the structures at the Foramen of Monro
  25. 25. Diagrammatic depiction of the anatomical structures which are to be identified by the neurosurgeon
  26. 26. The space between a & oc is Lamina terminalis Neuroendoscopic view of the third ventricle floor-----Infundibular recess (i), optic chiasm (oc) and a prominent anterior commissure (a) are seen anterior to the opaque and narrow tuber cinereum (t). B Neuroendoscopic view of the third ventricle floor in another myelomeningocele patient. A non-transparent tuber cinereum (t) and a dilated infundibular recess (i) are seen anterior to the mamillary bodies (m). Note to the vascular structure of the third ventricle floor. cNeuroendoscopic view showing a steep third ventricle floor in a myelomeningocele patient. A narrow tuber cinereum (t) is visible just anterior to the mamillary bodies (m). dNeuroendoscopic view through a very narrow prepontine cistern. Note the close proximity of the basillary artery (ba) and clivus (cl)
  27. 27. Endoscopic third ventricle from posteriorly -- a. Infundibular recess b. tuber cinereum c. mammillary bodies From front – through lamina terminalis
  28. 28. Tuber cinereum is laterally limited by Pcoms Endoscopic third ventricle from posteriorly -- a. Infundibular recess b. tuber cinereum c. mammillary bodies left posterior communicating artery (a), mammillary body (b), and right posterior hypoplasic communicating artery (c) --- measurement performed between the posterior communicating arteries using Geogebra software (a-b = 11.3 mm),
  29. 29. In the descriptive analysis of the 20 specimens, the PCoAs distance was 9 to 18.9 mm, mean of 12.5 mm, median of 12.2 mm, standard deviation of 2.3 mm.
  30. 30. See the basilar artery, PCA,SCA..... through ETV [Endoscopic Third Ventriculostomy ]
  31. 31. Great teachers – All this is their work . I am just the reader of their books . Prof. Paolo castelnuovo Prof. Aldo Stamm Prof. Mario Sanna Prof. Magnan
  32. 32. For Other powerpoint presentatioins of “ Skull base 360° ” I will update continuosly with date tag at the end as I am getting more & more information click www.skullbase360.in - you have to login to slideshare.net with Facebook account after clicking www.skullbase360.in

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