, Volume 54, Issue 12, pp 1341–1346 | Cite as

Bochdalek’s flower basket: applied neuroimaging morphometry and variants of choroid plexus in the cerebellopontine angles

  • Avril Horsburgh
  • Ramez W. Kirollos
  • Tarik F. MassoudEmail author
Diagnostic Neuroradiology



Protrusions of fourth ventricular choroid plexus through the foramina of Luschka are called ‘Bochdalek’s flower basket’ (BochFB). The bulbous terminal expansions (cornucopiae) extend into the cerebellopontine angle (CPA) cisterns. We studied and reviewed the normal imaging anatomy, morphometry and anatomical variants of BochFB.


We retrospectively analysed normal brain imaging findings on axial pre- and post-contrast CT scans and enhanced axial T1-weighted MRIs of 200 patients. We assessed BochFB for: (a) calcification, (b) lateral extension, (c) enhancement pattern, (d) cornucopiae shape, (e) symmetry and (f) proximity to tortuous vertebral arteries and morphometry of cornucopiae size and length of BochFB limbs.


BochFB calcification was found in 38 % of patients aged over 51 years. Lateral extension of BochFB into the CPA cistern was prominent in 75 % on CT and 96 % on MRI. The mean length of these extensions was 23.6 mm. BochFB enhanced strongly in 47 % on CT and 66 % on MRI. The BochFB cornucopiae were bulbous in 51 % on CT and 54 % on MRI. The mean width of bulbous cornucopiae was 3.5 mm. Bilateral BochFB symmetry was found in 71 % on CT and 80 % on MRI. Six to 8 % of tortuous left vertebral arteries were close to BochFB.


The cornucopiae are particularly well demonstrated on post-contrast MRI. However several sources of error in image interpretation may arise when imaging the normal BochFB on routine head CT and MRI. Difficulties in analysis arise especially on CT because of physiologic calcification, asymmetry, and the bulbous cornucopiae being mistaken for aneurysms.


Anatomy Bochdalek Choroid plexus Cerebellopontine angle Anterior inferior cerebellar artery 



TFM was supported by the NIHR Cambridge Biomedical Research Center.

Conflict of interest

We declare that we have no conflict of interest.


  1. 1.
    Sharifi M, Ciołkowski M, Krajewski P et al (2005) The choroid plexus of the fourth ventricle and its arteries. Folia Morphol 3:194–198Google Scholar
  2. 2.
    Fujii K, Lenkey C, Rhoton AL Jr (1980) Microsurgical anatomy of the choroidal arteries: fourth ventricle and the cerebellopontine angles. J Neurosurg 52:504–524PubMedCrossRefGoogle Scholar
  3. 3.
    Kachlik D, Cech P (2011) Vincenz Alexander Bochdalek (1801–83). J Med Biogr 19:38–43PubMedCrossRefGoogle Scholar
  4. 4.
    Hayman A, Evans RA, Hinck VC (1979) Choroid plexus of the fourth ventricle: a useful CT landmark. AJR 33:285–288Google Scholar
  5. 5.
    Netsky MG, Shuangshoti S (1975) The choroid plexus in health and disease. University Press of Virginia, Charlottesville, pp 151–160Google Scholar
  6. 6.
    Tanaka K, Sasayama T, Nishihara M et al (2009) Rapid regrowth of an atypical choroid plexus papilloma located in the cerebellopontine angle. J Clin Neurosci 16:121–124PubMedCrossRefGoogle Scholar
  7. 7.
    Matsushima T, Fukui M, Inoue T et al (1992) Microsurgical and magnetic resonance imaging anatomy of the cerebellomedullary fissure and its application during fourth ventricle surgery. Neurosurgery 30:325–330PubMedCrossRefGoogle Scholar
  8. 8.
    Kuchta J (2007) Twenty-five years of auditory brainstem implants: perspectives. Acta Neurochir 97:443–449CrossRefGoogle Scholar
  9. 9.
    Colletti V, Carner M, Miorelli V et al (2004) Auditory brainstem implant in posttraumatic cochlear nerve avulsion. Audiol Neuro Otol 9:247–255CrossRefGoogle Scholar
  10. 10.
    Lawlor DA, Stone T (2011) Public health and data protection: an inevitable collision or potential for a meeting of minds? Int J Epidemiol 30:1221–1225CrossRefGoogle Scholar
  11. 11.
    Schroter S, Plowman R, Hutchings A et al (2006) Reporting ethics committee approval and patient consent by study design in five general medical journals. J Med Ethics 32:718–723PubMedCrossRefGoogle Scholar
  12. 12.
    Dziegielewska KM, Ek J, Habgood MD, Saunders NR (2001) Development of the choroid plexus. Micros Res Tech 52:5–20CrossRefGoogle Scholar
  13. 13.
    Rhoton AL Jr (2000) Cerebellum and fourth ventricle. Neurosurgery 47:S7–S27PubMedCrossRefGoogle Scholar
  14. 14.
    Corrales M, Greitz T (1972) Fourth ventricle. Acta Radiol Diagn 12:113–131Google Scholar
  15. 15.
    Sharifi M, Ungier E, Ciszek B et al (2009) Microsurgical anatomy of the foramen of Luschka in the cerebellopontine angle, and its vascular supply. Surg Radiol Anat 31:431–437PubMedCrossRefGoogle Scholar
  16. 16.
    Modic M, Weinstein MA, Rothner AD et al (1980) Calcification of the choroid plexus visualized by computed tomography. Radiology 135:369–372PubMedGoogle Scholar
  17. 17.
    Virchow R (1864/1865) Die Krankhaften Geschwulste. Hirshwald 2:106–113Google Scholar
  18. 18.
    Bradac GB, Simon AS, Fiegler W et al (1976) A radioanatomcal study of the chonoid plexus of the fourth ventricle. Neuroradiology 11:87–91PubMedCrossRefGoogle Scholar
  19. 19.
    Jimenez-Castellanos J Jr, Jimenez-Castellanos J Sr, Carmona A, Catalina CJ (1992) Gross and applied anatomy of the anterior inferior cerebellar artery in the man with special reference to its course through the cerebellopontine angle region. Acta Anat 143:182–187PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Avril Horsburgh
    • 1
  • Ramez W. Kirollos
    • 2
  • Tarik F. Massoud
    • 1
    • 3
    • 4
    Email author
  1. 1.Department of RadiologyAddenbrooke’s HospitalCambridgeUK
  2. 2.Department of NeurosurgeryAddenbrooke’s HospitalCambridgeUK
  3. 3.Department of RadiologyUniversity of CambridgeCambridgeUK
  4. 4.University Department of Radiology, Addenbrooke’s HospitalUniversity of Cambridge School of Clinical MedicineCambridgeUK

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