Ventricles 360°.29-8-2015

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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

3rd ventricle

3rd ventricle entered through 1. Supra optic chiasmic route – by Lamina terminalis2. Infra optic chiasmic route – by Tuber cinerereum

Infra optic chiasmic route – by Tuber cinerereum

3rd ventricle entry through Tuber cinereum is laterally limited by Pcoms

Endoscopic third ventricle from posteriorly -- a. Infundibular recess b. tuber cinereum c. mammillarybodies

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),

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

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

Note LAMINA TERMINALIS IN

PTERIONAL APPROACH

Optic chiasma – infundibulum – Mamillarybodies

AcomA anterior communicating artery, CP choroid plexus, HT hypothalamus, MB mammillarybodies, 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.

Lateral ventricle

AnalogyEntry 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

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.

FM – Foramen of Monro

FM – Foramen of Monro

yellow arrow opening of the Silviusaqueduct

0 degree endoscope. The endoscope is inserted into the third ventricle behindthe pituitary stalk and from the left side. The posterior part of the ventricular

cavity is explored. - - From Atlas of Endoscopic Anatomy for Endonasal lntracranialSurgery ; Paolo Cappabianca

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

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

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

view.

Endoscopic Third Ventriculostomy ( ETV) in treatment of Hydrocephalushttp://drvksgautam.blogspot.in/2014/01/role-endoscopic-third-

ventriculostomy.html

Endoscope is passed from right lateral ventricle to third ventricle through Foramen of Monro

Intraoperative Endoscopic view of the structures at the Foramen of Monro

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

The space between a & oc is Lamina terminalisNeuroendoscopic 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)

Endoscopic third ventricle from posteriorly --a. Infundibular recess b. tuber cinereum c. mammillary bodies

From front – through lamina terminalis

Tuber cinereum is laterally limited by Pcoms

Endoscopic third ventricle from posteriorly -- a. Infundibular recess b. tuber cinereum c. mammillarybodies

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),

In the descriptive analysis of the 20 specimens, the PCoAsdistance was 9 to 18.9 mm, mean of 12.5 mm, median of 12.2

mm, standard deviation of 2.3 mm.

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

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

For Other powerpoint presentatioinsof

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