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Dorsal extensions of the fastigium cerebelli: an anatomical study using magnetic resonance imaging

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Abstract

Background and purpose

The fastigium cerebelli is an important topographical landmark for neurosurgeons and radiologists. However, few studies have characterized the morphology of the fastigium cerebelli. We aimed to investigate the fastigium cerebelli using postmortem specimens and magnetic resonance imaging (MRI) in vivo.

Materials and methods

Three cadaveric brains were midsagittally sectioned for observing the fastigium cerebelli. Additionally, 66 outpatients underwent MRI, including sagittal T1-weighted imaging, axial T2-weighted imaging, and coronal constructive interference in steady-state (CISS) sequence.

Results

In the cadaveric specimens, the fastigium cerebelli was observed as a beak-like dorsal protrusion of the fourth ventricle. Its inner surface was observed as a small fovea. On serial CISS images, the fastigium cerebelli consistently possessed a pair of triangular-shaped, dorsal extensions lying parasagittally along the nodule. These extensions were classified as symmetrical, right-side dominant, or left-side dominant. The symmetrical type was the most predominant and comprised 60.6% of the extensions, while the right-side dominant and left-side dominant types comprised 13.6 and 25.8%, respectively. In 91% of the 66 patients, the number of slices covering the entirety of the dorsal extensions were the same on both sides. The fastigial angle (θ) formed by lines tangent to the superior and inferior medullary velums varied widely.

Conclusions

The fastigium cerebelli has a pair of dorsal extensions lying parasagittally along the nodule. Coronal CISS sequence is useful in delineating the fastigium cerebelli in vivo.

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Acknowledgements

This study did not receive any grant funding.

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Authors and Affiliations

  1. Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan

    Satoshi Tsutsumi, Hisato Ishii & Yukimasa Yasumoto

  2. Department of Neurological Surgery, University of Pittsburgh School of Medicine, University of Pittsburg Medical Center, Pittsburgh, PA, USA

    Juan Carlos Fernandez-Miranda

  3. Division of Radiological Technology, Medical Satellite Yaesu Clinic, Tokyo, Japan

    Hideo Ono

Authors
  1. Satoshi Tsutsumi
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  2. Juan Carlos Fernandez-Miranda
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  3. Hisato Ishii
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  4. Hideo Ono
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  5. Yukimasa Yasumoto
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Contributions

ST and JCF-M developed the project of study. JCF-M performed cadaver dissection and collected anatomical data. HI and YY collected the imaging data. HO and HI analyzed the imaging data. ST wrote the manuscript.

Corresponding author

Correspondence to Satoshi Tsutsumi.

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Conflict of interest

The authors have no conflicts of interest to declare regarding the materials or methods in this study or the findings specified in this paper.

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Tsutsumi, S., Fernandez-Miranda, J.C., Ishii, H. et al. Dorsal extensions of the fastigium cerebelli: an anatomical study using magnetic resonance imaging. Surg Radiol Anat 40, 829–834 (2018). https://doi.org/10.1007/s00276-018-2023-3

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  • DOI: https://doi.org/10.1007/s00276-018-2023-3

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