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2022-08-03

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cc-by-nc-nd (c) Roldán, Pedro et al., 2022
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/216690

Endoscopic Anatomy of Transcallosal Hemispherotomy: Laboratory Study with Advanced Three-Dimensional Modeling

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Recurs relacionat

https://doi.org/10.1016/j.wneu.2022.05.042

Resum

Background: Epilepsy surgery has an important role in the treatment of patients with medically intractable seizures. Various authors have proposed an endoscopic technique to perform disconnective procedures. A detailed description of intracerebral anatomy seen through an endoscopic transcallosal corridor has not been reported. The aim of this study was to present a cadaveric step-by-step anatomical demonstration of endoscopic transcallosal hemispherotomy using a dedicated three-dimensional model. Methods: Anatomical dissections were performed on 6 cadaveric heads (12 hemispheres), and the disconnective procedure was performed using an endoscopic transcallosal approach. A dedicated three-dimensional model was used to better illustrate each step. A simulation of the disconnective procedure was performed by recreating the surgical steps on a subject from the Human Connectome Project dataset, and a calculation of the fiber tracts intersected was performed. Results: Analyzing data extracted from the three-dimensional model and tractography simulation, 100% of the fibers (streamlines) of corpus callosum, corticopontine tracts, corticospinal tract, and inferior fronto-occipital fascicle were transected. Moreover, a satisfactory number of fibers (>95%) of the thalamocortical tracts, corticostriatal tracts, corona radiata, fornix, and uncinate fascicle were disconnected. Conclusions: This anatomical study described the relevant neurovascular structures to enable prediction of feasibility and control of the surgical procedure using the endoscopic transcallosal approach. The quantitative analysis permitted estimation of the theoretical efficacy of the procedure, confirming its relevant role in disconnective surgery.

Matèries

Cirurgia endoscòpica, Cirurgia cerebral, Epilèpsia, Cadàvers

Matèries (anglès)

Endoscopic surgery, Cerebral surgery, Epilepsy, Cadavers

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Col·leccions

Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

ROLDÁN RAMOS, Pedro, GUIZZARDI, Giulia, DI SOMMA, Alberto, VALERA, Rene, VARRIANO, Federico, DONAIRE PEDRAZA, Antonio jesús, HOYOS, Jhon, TOPCZEWSKI, Thomaz e., TORALES, Jorge, ENSEÑAT NORA, Joaquim, RUMIÀ, Jordi, PRATS GALINO, Alberto. Endoscopic Anatomy of Transcallosal Hemispherotomy: Laboratory Study with Advanced Three-Dimensional Modeling. _World Neurosurgery_. 2022. Vol. 164, núm. e755-e763. [consulta: 23 de gener de 2026]. ISSN: 1878-8750. [Disponible a: https://hdl.handle.net/2445/216690]

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