Skip to main content

Advertisement

Log in

The Microsurgical Anatomy of the Cisternal Segment of the Trochlear Nerve, as Seen Through Different Neurosurgical Operative Windows

  • Case Retaport
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary.

Objective: To describe the anatomy of the cisternal segment of the trochlear nerve as seen through different neurosurgical approaches.

Methods: The cisternal course of ten trochlear nerves was observed in five cadaveric embalmed heads, through the view afforded by the median infratentorial-supracerebellar, the extreme-lateral infratentorial-supracerebellar, and the combined presigmoid-subtemporal transtentorial approaches. The relationships of the trochlear nerve with the surrounding neuro-vascular structures were analyzed.

Results: We identified 3 segments of the cisternal trochlear nerve: quadrigeminal, ambient and tentorial. The median infratentorial-supracerebellar approach allowed exposure of the quadrigeminal segment, including the origin of the nerve. The extreme-lateral supracerebellar and the combined presigmoid-subtemporal transtentorial approaches provided visualization of the ambient and tentorial segments of the nerve. The tentorial segment runs in a dural canal contained in the free edge of the tentorium, surrounded by its own arachnoidal sleeve.

Conclusion: The trochlear nerve is a very delicate structure that can be easily injured during approaches to the tentorial incisura. Accurate knowledge of its anatomy as seen through different operative windows is helpful in maintaining its integrity during surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Author information

Authors and Affiliations

Authors

Additional information

Published online December 5, 2002

 Correspondence: Mario Ammirati, M.D., Division of Neurosurgery, Albert Einstein Medical Center, Jefferson Health System, Klein Professional Building, Suite 501, 5401 Old York Road, Philadelphia, Pennsylvania 19141, U.S.A.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ammirati, M., Musumeci, A., Bernardo, A. et al. The Microsurgical Anatomy of the Cisternal Segment of the Trochlear Nerve, as Seen Through Different Neurosurgical Operative Windows. Acta Neurochir (Wien) 144, 1323–1327 (2002). https://doi.org/10.1007/s00701-002-1017-3

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-002-1017-3

Navigation