MICROSURGICAL AND ENDOSCOPIC ANATOMY OF LILIEQUIST'S MEMBRANE: A COMPLEX AND VARIABLE STRUCTURE OF THE BASAL CISTERNS
MICROSURGICAL AND ENDOSCOPIC ANATOMY OF LILIEQUIST'S MEMBRANE: A COMPLEX AND VARIABLE STRUCTURE OF THE BASAL CISTERNS
复制标题
利利奎斯特膜的显微外科和内窥镜解剖：基底池复杂多变的结构
DOI：
10.1227/01.neu.0000316419.49633.04
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发表时间：
2008
影响因子：
2.3
通讯作者：
J. Keller
中科院分区：
文献类型：
--
作者：
S. Froelich;K. A. Abdel Aziz;P. D. Cohen;H. van Loveren;J. Keller
目的文献中对Liliequist膜的描述差异很大。在我们对Liliequist膜的尸体研究中，我们试图阐明和定义其解剖特征和边界，以及其与周围神经血管结构的关系。我们描述了胚胎学的这一膜残留的初级幕。我们的研究结果的临床意义进行了讨论，就第三脑室底造瘘术和手术方法的基底动脉瘤，鞍上蛛网膜囊肿，中脑周围出血。方法对13具福尔马林固定的成人尸头进行彩色硅胶注射。在内窥镜下探查Liliequist膜后，进行了双侧额骨切开术，切除额叶以充分暴露Liliequist膜。结果Liliequist膜是一个复杂的和高度可变的结构，由单膜或两个叶片组成。在两个标本中，膜是缺席的，脚间，桥脑前和视交叉池之间没有任何明确的分界。结论了解Liliequist膜的解剖变异是重要的，特别是为了改善当前和即将到来的显微外科和内窥镜神经外科手术。它作为各种神经外科手术和多种病理过程（鞍上蛛网膜囊肿和中脑周围出血）的生理病理学中的手术地标非常重要。
OBJECTIVE Descriptions of Liliequist's membrane, as reported in the literature, vary considerably. In our cadaveric study of Liliequist's membrane, we attempted to clarify and define its anatomic features and boundaries, as well as its relationship with surrounding neurovascular structures. We describe the embryology of this membrane as a remnant of the primary tentorium. The clinical significance of our findings is discussed with respect to third ventriculostomy and surgical approaches to basilar tip aneurysms, suprasellar arachnoid cysts, and perimesencephalic hemorrhage. METHODS Thirteen formalin-fixed adult cadaveric heads were injected with colored silicone. After endoscopic exploration of Liliequist's membrane, a bilateral frontal craniotomy was performed, and the frontal lobes were removed to fully expose Liliequist's membrane. RESULTS Liliequist's membrane is a complex and highly variable structure that is composed of either a single membrane or two leaves. The membrane was absent in two specimens without any clear demarcation between the interpeduncular, prepontine, and chiasmatic cisterns. CONCLUSION Understanding the variable anatomy of Liliequist's membrane is important, particularly to improve current and forthcoming microsurgical and endoscopic neurosurgical procedures. It is important as a surgical landmark in various neurosurgical operations and in the physiopathology of several pathological processes (suprasellar arachnoid cysts and perimesencephalic hemorrhage).