1. The document discusses the anatomy of the ventricles and surrounding structures as seen during endoscopic procedures like endoscopic third ventriculostomy. It describes entry routes into the third ventricle via the lamina terminalis and tuber cinereum. 2. Key structures discussed include the foramen of Monro, posterior communicating arteries, mammillary bodies, infundibular recess, and optic chiasm. Analogies are made between ventricle anatomy and sinus anatomy. 3. Images show endoscopic views of the third ventricle floor and surrounding structures like the tuber cinereum, mammillary bodies, and posterior communicating arteries. Measurements between the PCoAs are also provided

1. Ventricles 360°.
29-8-2015

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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. 3rd ventricle

5. 3rd ventricle entered through
1. Supra optic chiasmic route – by Lamina terminalis
2. Infra optic chiasmic route – by Tuber cinerereum

6. Infra optic chiasmic route – by Tuber
cinerereum

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. 3rd ventricle entry by - Supra optic chiasmic route – by
Lamina terminalis

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. Note LAMINA
TERMINALIS IN
PTERIONAL APPROACH

14. Optic chiasma – infundibulum – Mamillary
bodies

15. 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.

16. Lateral ventricle

17. 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

18. 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.

19. FM – Foramen of Monro

21. FM – Foramen of Monro

22. yellow arrow opening of the Silvius
aqueduct

23. 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

24. 00 endoscope. The endoscope is approached closer to
the pineal recess.

25. 30° endoscope. The endoscope is
turned to the right side.

26. 30° endoscope. The endoscope is orientated upwards
and approached closer to the pineal recess. Closer
view.

27. 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

28. Intraoperative Endoscopic view of the
structures at the Foramen of Monro

29. Diagrammatic depiction of the
anatomical structures which
are to be identified by the
neurosurgeon

30. 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)

31. Endoscopic third
ventricle from
posteriorly --
a. Infundibular recess b.
tuber cinereum c.
mammillary bodies
From front – through
lamina terminalis

32. 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),

33. 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.

34. See the basilar artery, PCA,SCA..... through ETV
[Endoscopic Third Ventriculostomy ]

35. 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

36. 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
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