Microsurgical anatomy of the posterior cerebral artery in three-dimensional images. 2011

Richard Gonzalo Párraga, and Guilherme Carvalhal Ribas, and Sergio Eduardo Gómez Llata Andrade, and Evandro de Oliveira
Microneurosurgery Laboratory, Beneficência Portuguesa Hospital and the Institute of Neurological Sciences, São Paulo, Brazil. rick_parraga@hotmail.com

OBJECTIVE To describe the microsurgical anatomy, branches, and anatomic relationships of the posterior cerebral artery (PCA) represented in three-dimensional images. METHODS Seventy hemispheres of 35 brain specimens were studied. They were previously injected with red silicone and fixed in 10% formalin for at least 40 days. Four of the studied specimens were frozen at -10° to -15 °C for 14 days, and additional dissection was done with the Klingler's fiber dissection technique at ×6 to ×40 magnification. Each segment of the artery was measured and photographed to obtain three-dimensional stereoscopic images. RESULTS The PCA origin was in the interpeduncular cistern at the pontomesencephalic junction level in 23 specimens (65.7%). The PCA was divided into four segments: P1 extends from the PCA origin to its junction with the posterior communicating artery with an average length of 7.7 mm; P2 was divided into an anterior and posterior segment. The P2A segment begins at the posterior communicating artery and ends at the most lateral aspect of the cerebral peduncle, with an average length of 23.6 mm, and the P2P segment extends from the most lateral aspect of the cerebral peduncle to the posterior edge of the lateral surface of the midbrain, with an average length of 16.4 mm; P3 extends from the posterior edge of the lateral surface of the midbrain and ends at the origin of the parieto-occipital sulcus along the calcarine fissure, with an average length of 19.8 mm; and the P4 segment corresponds to the parts of the PCA that run along or inside both the parieto-occipital sulcus and the distal part of the calcarine fissure. CONCLUSIONS To standardize the neurosurgical practice and knowledge, surgical anatomic classifications should be used uniformly and further modified according to the neurosurgical experience gathered. The PCA classification proposed intends to correlate its anatomic segments with their required microneurosurgical approaches.

UI MeSH Term Description Entries
D008866 Microsurgery The performance of surgical procedures with the aid of a microscope.
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D002102 Cadaver A dead body, usually a human body. Corpse,Cadavers,Corpses
D002831 Choroid Plexus A villous structure of tangled masses of BLOOD VESSELS contained within the third, lateral, and fourth ventricles of the BRAIN. It regulates part of the production and composition of CEREBROSPINAL FLUID. Chorioid Plexus,Plexus Choroideus,Choroideus, Plexus,Plexus, Chorioid,Plexus, Choroid
D004210 Dissection The separation and isolation of tissues for surgical purposes, or for the analysis or study of their structures. Dissections
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013699 Temporal Arteries Arteries arising from the external carotid or the maxillary artery and distributing to the temporal region. Arteries, Temporal,Artery, Temporal,Temporal Artery
D019635 Neurosurgical Procedures Surgery performed on the nervous system or its parts. Procedures, Neurosurgical,Surgical Procedures, Neurologic,Neurologic Surgical Procedure,Neurologic Surgical Procedures,Neurosurgical Procedure,Procedure, Neurologic Surgical,Procedure, Neurosurgical,Procedures, Neurologic Surgical,Surgical Procedure, Neurologic
D020769 Posterior Cerebral Artery Artery formed by the bifurcation of the BASILAR ARTERY. Branches of the posterior cerebral artery supply portions of the OCCIPITAL LOBE; PARIETAL LOBE; inferior temporal gyrus, brainstem, and CHOROID PLEXUS. Cerebral Artery, Posterior,Arteries, Posterior Cerebral,Artery, Posterior Cerebral,Cerebral Arteries, Posterior,Posterior Cerebral Arteries
D021621 Imaging, Three-Dimensional The process of generating three-dimensional images by electronic, photographic, or other methods. For example, three-dimensional images can be generated by assembling multiple tomographic images with the aid of a computer, while photographic 3-D images (HOLOGRAPHY) can be made by exposing film to the interference pattern created when two laser light sources shine on an object. Computer-Assisted Three-Dimensional Imaging,Imaging, Three-Dimensional, Computer Assisted,3-D Image,3-D Imaging,Computer-Generated 3D Imaging,Three-Dimensional Image,Three-Dimensional Imaging, Computer Generated,3 D Image,3 D Imaging,3-D Images,3-D Imagings,3D Imaging, Computer-Generated,3D Imagings, Computer-Generated,Computer Assisted Three Dimensional Imaging,Computer Generated 3D Imaging,Computer-Assisted Three-Dimensional Imagings,Computer-Generated 3D Imagings,Image, 3-D,Image, Three-Dimensional,Images, 3-D,Images, Three-Dimensional,Imaging, 3-D,Imaging, Computer-Assisted Three-Dimensional,Imaging, Computer-Generated 3D,Imaging, Three Dimensional,Imagings, 3-D,Imagings, Computer-Assisted Three-Dimensional,Imagings, Computer-Generated 3D,Imagings, Three-Dimensional,Three Dimensional Image,Three Dimensional Imaging, Computer Generated,Three-Dimensional Images,Three-Dimensional Imaging,Three-Dimensional Imaging, Computer-Assisted,Three-Dimensional Imagings,Three-Dimensional Imagings, Computer-Assisted

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