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Microsurgical Anatomy of the White Matter Tracts of Brainstem and Cerebellum

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Abstract

The brainstem is located in the posterior fossa and is a critical center that regulates vital autonomic functions and relays motor and sensory information between the brain and spinal cord. The midbrain is located between the diencephalon and the pons. In an axial view of the midbrain, three structures can be visualized, from anterior to posterior: cerebral peduncles, tegmentum and tectum or quadrigeminal plate. The pons is cubic-shaped and is located between the midbrain and the medulla. In addition, is formed by a ventral part and a tegmental part, and constituted the superior part of the fourth ventricle. The medulla is located between spinal cord and the pons. The inferior limit constitutes the ventral root of the first cervical spinal nerve and the pyramidal decussation and the superior limit constitutes the pontomedullary sulcus. The floor of the fourth ventricle is divided into three parts: (1) the superior or pontine part; (2) the intermediate or junctional part; and (3) the inferior or medullary part. The cerebellum is located in the posterior cranial fossa behind the fourth ventricle, the pons, and the medulla oblongata and is formed for two hemispheres and a medial structure named vermis. From a surgical perspective, Prof. Rhoton divided the cerebellum into three faces: the tentorial surface, suboccipital surface and petrosal surface. A complete understanding of the tridimensional view of the microsurgical anatomy of the brainstem can greatly aid the surgeon in selecting the most appropriate surgical corridor.

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Hospital Juárez de México, Mexico City, Mexico

    Nataly Mireya Alvear-Quito

  2. Department of Neurosurgery. Aurora Neuroscience Innovation Institute, Aurora St. Luke’s Medical Center, Milwaukee, WI, USA

    Srikant S. Chakravarthi, Austin Epping & Alejandro Monroy-Sosa

  3. Skull Base and Cerebrovascular Laboratory, Advocate Aurora Research Institute, Milwaukee, WI, USA

    Srikant S. Chakravarthi, Austin Epping & Alejandro Monroy-Sosa

  4. Faculty of Medicine, Tecnologico de Monterrey, Mexico City, Mexico

    María Fernanda Tejada-Pineda

  5. Neeka Health LLC, Milwaukee, WI, USA

    Amin B. Kassam

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  1. Nataly Mireya Alvear-Quito
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  2. Srikant S. Chakravarthi
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  3. Austin Epping
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  4. María Fernanda Tejada-Pineda
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  6. Alejandro Monroy-Sosa
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Correspondence to Alejandro Monroy-Sosa .

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Editors and Affiliations

  1. Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Milwaukee, WI, USA

    Alejandro Monroy-Sosa

  2. Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Milwaukee, WI, USA

    Srikant S. Chakravarthi

  3. Instituto Nacional de Cancerología, Mexico City, Mexico

    Jaime G. de la Garza-Salazar

  4. Instituto Nacional de Cancerología, Mexico City, Mexico

    Abelardo Meneses Garcia

  5. Neeka Health, LLC, Milwaukee, WI, USA

    Amin B. Kassam

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Alvear-Quito, N.M., Chakravarthi, S.S., Epping, A., Tejada-Pineda, M.F., Kassam, A.B., Monroy-Sosa, A. (2021). Microsurgical Anatomy of the White Matter Tracts of Brainstem and Cerebellum. In: Monroy-Sosa, A., Chakravarthi, S.S., de la Garza-Salazar, J.G., Meneses Garcia, A., Kassam, A.B. (eds) Principles of Neuro-Oncology. Springer, Cham. https://doi.org/10.1007/978-3-030-54879-7_9

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  • DOI: https://doi.org/10.1007/978-3-030-54879-7_9

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