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KMID : 1150320090050020142
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Journal of Korean Society of Geriatric Neurosurgery
2009 Volume.5 No. 2 p.142 ~ p.148
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Intraoperative Microsurgical Anatomical Variations of Sylvian Veins and Cisterns
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Jeon Jee-Ho
Hwang Hyung-Sik
Jeong Je-Hoon
Moon Seung-Myung
Choi Sun-Kil
Oh Sae-Moon
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Abstract
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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.
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KEYWORD
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Sylvian vein, Sylvian cistern, Pterional approach
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