| Intraoperative Microsurgical Anatomical Variations of
Sylvian Veins and Cisterns |
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Jee Ho Jeon1 , Hyung Sik Hwang1 , Je Hoon Jeong1, Seung Myung Moon1 , Sun Kil Choi MD1 , Sae Moon Oh2 |
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1Department of Neurosurgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
2Department of Neurosurgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea |
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| Abstract |
Objective
We analyzed the intraoperative anatomical findings and variations of sylvian veins and cisterns.
Materials
From Jan. 2007 to Mar. 2008, we classified the variations of sylvian veins with 68 aneurysmal patients according to Yasagil’s
classification. Type I: The fronto-orbital, fronto-parietal and anterior temporal veins drain into one superficial sylvian vein (SSV). II: Two
SSVs into the sphenoparietal (SPS) and Rosenthal’s vein. III: Two SSVs into SPS and superior petrosal veins. IV: Hypoplastic SSV.
According to Kazumata’s classification of its branching more precisely, we classified the variations of SV, Type A: SSV drain into the
SPS, B: frontobasal vein (FBBV) into SSV, C: Deep middle cerebral vein (DMCV) into SSV, D: Both DMCV and FBBV into SSV. The variations
of sylvian cistern were classified into types of sylvian, frontal and temporal by the relationship between the lateral fronto-orbital
gyrus and superior temporal gyrus. The width of cistern between the frontal and temporal lobes are loosely (A-large), closely (B-narrow) or
very closely (C-sticky).
Result: In Yasagil’s classification, type I, II, III and IV were observed in 51.5% (n=35), 17.6% (n=12), 13.3% (n=9) and 17.6% (n=12),
respectively. In Kazumata’s classification, type A, B, C and D were 26.5% (n=18), 19.1% (n=13), 13.2% (n=9) and 27.9% (n=19). Among
the cistern of sylvian, A, B and C were 44.1% (n=30), 41.2% (n=28) and 2.94% (n=2).
Conclusion
The variations of sylvian fissure should be recognized in the field of pterional approach during learning curve. |
| Key Words:
Sylvian veinㆍSylvian cisternㆍPterional approach |
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