Abstract
The armamentarium of neuroendoscopy developed in the last years, allowing advanced procedures to be accomplished using minimally invasive route. However, having the technology doesn’t mean much without knowledge of the ventricle anatomy. Knowing the normal anatomy and its variations will allow planning the safest trajectory and minimize complications.
Once inside lateral ventricle, using the precoronal approach, the part of the lateral ventricle surrounding the interventricular foramen is visualized. Knowing anatomical landmarks of lateral ventricles, frontal horn, foramen of Monro, choroid plexus, venous angle, and septum pellucidum can be of immense help navigating both normal and distorted anatomical circumstances.
During the septostomy, the burr hole is positioned more laterally, about 4 cm from the midline, on the side of the enlarged ventricle. Septum pellucidum is seen with its two layers separating frontal horns and bodies of the lateral ventricles in the midline.
Under normal circumstances, the third ventricle is a very narrow space in the midline, just inferior to the lateral ventricles. However, in hydrocephalus it becomes large enough to visualize clearly its many important landmarks: anterior commissure, optic chiasm, infundibular recess, dorsum sellae, floor of the third ventricle, mammillary bodies, aditus of the cerebral aqueduct, posterior commissure, pineal recess, suprapineal recess, and mass intermedia.
The fourth ventricle is visualized through a suboccipital approach. Firstly, opening of the cerebral aqueduct is in the field of view, the most superior part of the fourth ventricle. Other important landmarks are fossa rhomboidea, choroid plexus, striae medullaris, foramen of Magendie, and foramina Luschka.
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Özek, M.M., Zivkovic, B. (2019). Neuroendoscopic Anatomy of the Ventricles. In: Cinalli, G., Özek, M., Sainte-Rose, C. (eds) Pediatric Hydrocephalus. Springer, Cham. https://doi.org/10.1007/978-3-319-27250-4_78
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