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Microsurgical Anatomy of the Cerebellomedullary Fissure and Variations of the Transcerebellomedullary Fissure Approach

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Microsurgical Anatomy and Surgery of the Posterior Cranial Fossa

Abstract

Figure 7.1 is an illustration of an intraoperative view of a distal posterior inferior cerebellar artery (PICA) aneurysm. Some neurosurgeons must have had their own experiences of opening the cerebellomedullary fissure (CMF) during surgery, such as the clipping of the distal PICA aneurysm, before our first report of the transcerebellomedullary fissure approach (trans-CMF approach) [10, 21]. The CMF is the biggest cleavage plane of the three cerebellar–brainstem fissures. Opening the CMF is useful during various surgeries in the lower posterior cranial fossa in the same way as opening the Sylvian fissure in supratentorial surgeries. We proposed the trans-CMF approach as an approach utilizing the opening of any part of the CMF and have developed several variations [9, 10, 12, 13, 20–22, 26, 30, 31, 33, 34, 36]. In this chapter, the anatomy of the CMF, the evolution and concept of the trans-CMF approach, and the variations of the approach, such as the medial and lateral routes and the unilateral trans-CMF approach, are explained.

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  1. Department of Neurosurgery Faculty of Medicine, Saga University, Saga, Japan

    Toshio Matsushima

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Matsushima, T. (2015). Microsurgical Anatomy of the Cerebellomedullary Fissure and Variations of the Transcerebellomedullary Fissure Approach. In: Microsurgical Anatomy and Surgery of the Posterior Cranial Fossa. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54183-7_7

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  • DOI: https://doi.org/10.1007/978-4-431-54183-7_7

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  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-54182-0

  • Online ISBN: 978-4-431-54183-7

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