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Anatomical variations and neurosurgical significance of Liliequist’s membrane

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Abstract

Introduction

Liliequist’s membrane is an arachnoid membrane that forms a barrier within the basilar cisternal complex. This structure is an important landmark in approaches to the sellar and parasellar regions. The importance of this membrane was largely recognized after the advance of neuroendoscopic techniques. Many studies were, thereafter, published reporting different anatomic findings.

Method

A detailed search for studies reporting anatomic and surgical findings of Liliequist’s membrane was performed using “PubMed,” and included all the available literature. Manual search for manuscripts was also conducted on references of papers reporting reviews.

Results

Liliequist’s membrane has received more attention recently. The studies have reported widely variable results, which were systematically organized in this paper to address the controversy.

Conclusion

Regardless of its clinical and surgical significance, the anatomy of Liliequist’s membrane is still a matter of debate.

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References

  1. Key A, Retzius M (1875) Studien in der Anatomie des Nervensystems und des Bindegewebes, Germany

  2. Liliequist B (1956) The anatomy of the subarachnoid cisterns. Acta Radiol 46:61–71

    Article  CAS  PubMed  Google Scholar 

  3. Liliequist B (1959) The subarachnoid cisterns. An anatomic and roentgenologic study. Acta Radiol Suppl 185:1–108

    CAS  PubMed  Google Scholar 

  4. Yasargil MG, Kasdaglis K, Jain KK, Weber HP (1976) Anatomical observations of the subarachnoid cisterns of the brain during surgery. J Neurosurg 44:298–302

    Article  CAS  PubMed  Google Scholar 

  5. Froelich SC, Abdel Aziz KM, Cohen PD, van Loveren HR, Keller JT (2008) Microsurgical and endoscopic anatomy of Liliequist’s membrane: a complex and variable structure of the basal cisterns. Neurosurgery 63:ONS1-8, discussion ONS8-9

    Article  Google Scholar 

  6. Zhang M, An PC (2000) Liliequist’s membrane is a fold of the arachnoid mater: study using sheet plastination and scanning electron microscopy. Neurosurgery 47:902–908, discussion 908–909

    Article  CAS  PubMed  Google Scholar 

  7. Brasil AV, Schneider FL (1993) Anatomy of Liliequist’s membrane. Neurosurgery 32:956–960, discussion 960–951

    Article  CAS  PubMed  Google Scholar 

  8. Matsuno H, Rhoton AL Jr, Peace D (1988) Microsurgical anatomy of the posterior fossa cisterns. Neurosurgery 23:58–80

    Article  CAS  PubMed  Google Scholar 

  9. Yaşargil MG (1984) Microsurgical anatomy of the basal cisterns and vessels of the brain: diagnostic studies, general operative techniques and pathological considerations of the intracranial aneurysms. Thieme, New York

    Google Scholar 

  10. Vinas FC, Panigrahi M (2001) Microsurgical anatomy of the Liliequist’s membrane and surrounding neurovascular territories. Minim Invasive Neurosurg 44:104–109

    Article  CAS  PubMed  Google Scholar 

  11. Epstein BS (1965) The role of a transverse arachnoidal membrane within the interpeduncular cistern in the passage of pantopaque into the cranial cavity. Radiology 85:914–920

    Article  CAS  PubMed  Google Scholar 

  12. Fox JL (1989) Atlas of neurosurgical anatomy: the pterional perspective. Springer, New York

    Book  Google Scholar 

  13. Anik I, Ceylan S, Koc K, Tugasaygi M, Sirin G, Gazioglu N, Sam B (2011) Microsurgical and endoscopic anatomy of Liliequist’s membrane and the prepontine membranes: cadaveric study and clinical implications. Acta Neurochir 153:1701–1711

    Article  PubMed  Google Scholar 

  14. Fushimi Y, Miki Y, Ueba T, Kanagaki M, Takahashi T, Yamamoto A, Haque TL, Konishi J, Takahashi JA, Hashimoto N (2003) Liliequist membrane: three-dimensional constructive interference in steady state MR imaging. Radiology 229:360–365, discussion 365

    Article  PubMed  Google Scholar 

  15. Zhang XA, Qi ST, Huang GL, Long H, Fan J, Peng JX (2012) Anatomical and histological study of Liliequist’s membrane: with emphasis on its nature and lateral attachments. Childs Nerv Syst 28:65–72

    Article  PubMed  Google Scholar 

  16. Buxton N, Vloeberghs M, Punt J (1998) Liliequist’s membrane in minimally invasive endoscopic neurosurgery. Clin Anat 11:187–190

    Article  CAS  PubMed  Google Scholar 

  17. Inoue K, Seker A, Osawa S, Alencastro LF, Matsushima T, Rhoton AL Jr (2009) Microsurgical and endoscopic anatomy of the supratentorial arachnoidal membranes and cisterns. Neurosurgery 65:644–664, discussion 665

    Article  PubMed  Google Scholar 

  18. Lu J, Zhu XI (2003) Microsurgical anatomy of Liliequist’s membrane. Minim Invasive Neurosurg 46:149–154

    Article  CAS  PubMed  Google Scholar 

  19. Wang SS, Zheng HP, Zhang FH, Wang RM (2011) Microsurgical anatomy of Liliequist’s membrane demonstrating three-dimensional configuration. Acta Neurochir 153:191–200

    Article  PubMed  Google Scholar 

  20. Vinas FC, Dujovny M, Fandino R, Chavez V (1996) Microsurgical anatomy of the infratentorial trabecular membranes and subarachnoid cisterns. Neurol Res 18:117–125

    CAS  PubMed  Google Scholar 

  21. Vinas FC, Dujovny M, Fandino R, Chavez V (1996) Microsurgical anatomy of the arachnoidal trabecular membranes and cisterns at the level of the tentorium. Neurol Res 18:305–312

    CAS  PubMed  Google Scholar 

  22. Vinas FC, Fandino R, Dujovny M, Chavez V (1994) Microsurgical anatomy of the supratentorial arachnoidal trabecular membranes and cisterns. Neurol Res 16:417–424

    CAS  PubMed  Google Scholar 

  23. Qi ST, Fan J, Zhang XA, Pan J (2011) Reinvestigation of the ambient cistern and its related arachnoid membranes: an anatomical study. J Neurosurg 115:171–178

    Article  PubMed  Google Scholar 

  24. Lu J, Zhu XL (2007) Cranial arachnoid membranes: some aspects of microsurgical anatomy. Clin Anat 20:502–511

    Article  PubMed  Google Scholar 

  25. Lu J, Zhu XL (2005) Characteristics of distribution and configuration of intracranial arachnoid membranes. Surg Radiol Anat 27:472–481

    Article  PubMed  Google Scholar 

  26. Hellwig D, Bauer B, Riegel T, Schmidek H, Sweet W (2000) Surgical management of arachnoid, suprasellar and Rathke’s cleft cysts. In: Schmidek H (ed) Operative neurosurgical techniques, 4th edn. Saunders, Philadelphia, pp 513–532

    Google Scholar 

  27. Rengachary SS, Watanabe I (1981) Ultrastructure and pathogenesis of intracranial arachnoid cysts. J Neuropathol Exp Neurol 40:61–83

    Article  CAS  PubMed  Google Scholar 

  28. Sugita K, Kobayashi S, Shintani A, Mutsuga N (1979) Microneurosurgery for aneurysms of the basilar artery. J Neurosurg 51:615–620

    Article  CAS  PubMed  Google Scholar 

  29. Tulleken CA, Luiten ML (1986) The basilar artery bifurcation in situ approached via the Sylvian route (50×). An anatomical study in human cadavers. Acta Neurochir 80:109–115

    Article  CAS  PubMed  Google Scholar 

  30. Morota N, Watabe T, Inukai T, Hongo K, Nakagawa H (2000) Anatomical variants in the floor of the third ventricle; implications for endoscopic third ventriculostomy. J Neurol Neurosurg Psychol 69:531–534

    Article  CAS  Google Scholar 

  31. Oi S, Shimoda M, Shibata M, Honda Y, Togo K, Shinoda M, Tsugane R, Sato O (2000) Pathophysiology of long-standing overt ventriculomegaly in adults. J Neurosurg 92:933–940

    Article  CAS  PubMed  Google Scholar 

  32. Etus V, Solakoglu S, Ceylan S (2011) Ultrastructural changes in the Liliequist membrane in the hydrocephalic process and its implications for the endoscopic third ventriculostomy procedure. Turk Neurosurg 21:359–366

    PubMed  Google Scholar 

  33. Melikian G, Arutiunov NV, Melnikov AV (2003) Unusual intraventricular herniation of the suprasellar arachnoid cyst and its successful endoscopic management. Minim Invasive Neurosurg 46:113–116

    Article  CAS  PubMed  Google Scholar 

  34. Rhoton AL Jr (2000) Tentorial incisura. Neurosurgery 47:S131–S153

    Article  PubMed  Google Scholar 

  35. Lu J, Zhu X (2005) Microsurgical anatomy of the interpeduncular cistern and related arachnoid membranes. J Neurosurg 103:337–341

    Article  PubMed  Google Scholar 

  36. Ceylan S, Koc K, Anik I (2009) Extended endoscopic approaches for midline skull-base lesions. Neurosurg Rev 32:309–319, discussion 318–309

    Article  PubMed  Google Scholar 

  37. Ceylan S, Koc K, Anik I (2011) Extended endoscopic transphenoidal approach for tuberculum sellae meningiomas. Acta Neurochir 153:1–9

    Article  PubMed  Google Scholar 

  38. de Divitiis E, Cappabianca P, Cavallo LM, Esposito F, de Divitiis O, Messina A (2007) Extended endoscopic transsphenoidal approach for extrasellar craniopharyngiomas. Neurosurgery 61:219–227, discussion 228

    Article  PubMed  Google Scholar 

  39. de Divitiis E, Cavallo LM, Esposito F, Stella L, Messina A (2008) Extended endoscopic transsphenoidal approach for tuberculum sellae meningiomas. Neurosurgery 62:1192–1201

    PubMed  Google Scholar 

  40. Frank G, Sciarretta V, Calbucci F, Farneti G, Mazzatenta D, Pasquini E (2006) The endoscopic transnasal transsphenoidal approach for the treatment of cranial base chordomas and chondrosarcomas. Neurosurgery 59:ONS50-57, discussion ONS50-57

    Google Scholar 

  41. Rinkel GJ, Wijdicks EF, Vermeulen M, Hasan D, Brouwers PJ, van Gijn J (1991) The clinical course of perimesencephalic nonaneurysmal subarachnoid hemorrhage. Ann Neurol 29:463–468

    Article  CAS  PubMed  Google Scholar 

  42. Rinkel GJ, Wijdicks EF, Vermeulen M, Ramos LM, Tanghe HL, Hasan D, Meiners LC, van Gijn J (1991) Nonaneurysmal perimesencephalic subarachnoid hemorrhage: CT and MR patterns that differ from aneurysmal rupture. AJNR 12:829–834

    CAS  PubMed  Google Scholar 

  43. Schroeder HW, Gaab MR (1997) Endoscopic observation of a slit-valve mechanism in a suprasellar prepontine arachnoid cyst: case report. Neurosurgery 40:198–200

    CAS  PubMed  Google Scholar 

  44. Schwartz TH, Solomon RA (1996) Perimesencephalic nonaneurysmal subarachnoid hemorrhage: review of the literature. Neurosurgery 39:433–440, discussion 440

    CAS  PubMed  Google Scholar 

  45. Binitie O, Williams B, Case CP (1984) A suprasellar subarachnoid pouch; aetiological considerations. J Neurol Neurosurg Psychol 47:1066–1074

    Article  CAS  Google Scholar 

  46. Fox JL, Al-Mefty O (1980) Suprasellar arachnoid cysts: an extension of the membrane of Liliequist. Neurosurgery 7:615–618

    Article  CAS  PubMed  Google Scholar 

  47. Miyajima M, Arai H, Okuda O, Hishii M, Nakanishi H, Sato K (2000) Possible origin of suprasellar arachnoid cysts: neuroimaging and neurosurgical observations in nine cases. J Neurosurg 93:62–67

    Article  CAS  PubMed  Google Scholar 

  48. Raimondi AJ, Shimoji T, Gutierrez FA (1980) Suprasellar cysts: surgical treatment and results. Childs Brain 7:57–72

    CAS  PubMed  Google Scholar 

  49. Crimmins DW, Pierre-Kahn A, Sainte-Rose C, Zerah M (2006) Treatment of suprasellar cysts and patient outcome. J Neurosurg 105:107–114

    PubMed  Google Scholar 

  50. Sommer IE, Smit LM (1997) Congenital supratentorial arachnoidal and giant cysts in children: a clinical study with arguments for a conservative approach. Childs Nerv Syst 13:8–12

    Article  CAS  PubMed  Google Scholar 

  51. Gui SB, Wang XS, Zong XY, Zhang YZ, Li CZ (2011) Suprasellar cysts: clinical presentation, surgical indications, and optimal surgical treatment. BMC Neurol 11:52

    Article  PubMed Central  PubMed  Google Scholar 

  52. Moon KS, Lee JK, Kim JH, Kim SH (2007) Spontaneous disappearance of a suprasellar arachnoid cyst: case report and review of the literature. Childs Nerv Syst 23:99–104

    Article  PubMed  Google Scholar 

  53. Pierre-Kahn A, Hanlo P, Sonigo P, Parisot D, McConnell RS (2000) The contribution of prenatal diagnosis to the understanding of malformative intracranial cysts: state of the art. Childs Nerv Syst 16:619–626

    CAS  PubMed  Google Scholar 

  54. Adeeb N, Deep A, Griessenauer CJ, Mortazavi MM, Watanabe K, Loukas M, Tubbs RS, Cohen-Gadol AA (2013) The intracranial arachnoid mater : a comprehensive review of its history, anatomy, imaging, and pathology. Childs Nerv Syst 29:17–33

    Article  PubMed  Google Scholar 

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Correspondence to Martin M. Mortazavi.

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Mortazavi, M.M., Rizq, F., Harmon, O. et al. Anatomical variations and neurosurgical significance of Liliequist’s membrane. Childs Nerv Syst 31, 15–28 (2015). https://doi.org/10.1007/s00381-014-2590-5

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  • DOI: https://doi.org/10.1007/s00381-014-2590-5

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