Table Of ContentWolfgang Seeger
Anatomical
for
Dissections Use
i n Neurosurgery
1
Vol.
In Collaboration with
H. R. Eggert
Springer-Verlag Wien NewYork
Prof. Dr. med. WOLFGANG SEEGER
Medical Director ofthe Department of General Neurosurgery
and Chairman of Neurosurgery of the Neurosurgical Clinic
PD Dr. HANS-RuDOLF EGGERT
Department of General Neurosurgery, Neurosurgical Clinic
University ofFreiburg i. Br., Federal Republic of Germany
With 150 Figures
This work is subject to copyright
All rights are reserved, whether the wholeor partofthe material isconcerned, specificallythoseoftranslation,reprinting,
re-use of illustrations, broadcasting, reproduction by photocopying machine or similar means, and storage in data banks
© 1987 by Springer-VerlaglWien
Printed in Austria
Library ofCongressCataloging-in-Publication Data
Seeger, Wolfgang, 1929- . Anatomical dissections for use in neurosurgery. Includes bibliographies and index. 1. Brain-Surgery.
2. Brain-Dissection. I. Eggert, H. R. (Hans-Rudolf) II. Title. [DNLM: 1. Brain-anatomy & histology. 2. Dissection. 3. Neurosurgery
methods. WL 368S451a] RD594.S423 1987. 617'.48 .87-16692.
ISBN 3-211-81998-3 Springer-Verlag Wien-New York
ISBN 0-387-81998-3 Springer-Verlag New York-Wien
Dr. Karl Vossschuite
Professor emeritus of Surgery, Justus-Liebig-Universitiit Giessen
to his anniversary
8()h
PREFACE '-- 1VII
---1
Preface
This book is published in two volumes. Velum medullare posterior in the area of the 4th
In this first volume, an attempt is made to give young ventricle, including the choroid point of the PICA,
neurosurgeons methodical instruction in the dissec can be studied exactly. These examples were chosen
tion of formaldehyde-preserved brains. This book, because exact topographical knowledge of these ves
however, is not intended to be taken as a textbook on sel-richstructuresisofteninadequate; andwhenusing
anatomy. Conventional presentations ofthe anatomy modern operative techniques, increasingly more op
ofthe brain must present, step by step, the individual erations are performed in just these particular areas.
systems of the organ according to its developmental These dissections compose the content of the first
and functional aspects, e. g. cortex, limbic system, volume.
basal ganglia, brainstem, and cerebellum. Because The second volume is intended for experienced
during a single operation the neurosurgeon is some neurosurgeons who performcomplexoperationsdeep
times confronted with all the various systems, it is inside the brain. Some of these operations have be
necessary to perform brain dissections from the view come standardized, e. g. the opening of the sylvian
point of operative approaches. Therefore, in this fissure with operations in the area of the Insula and
work the attempt is made to keep certain individual cranial base. Other complex operations are per
surface structures, e. g. the Gyrus praecentralisintact formed seldom even today, e. g. approaches to the
until the end of the dissection so that the relative 3rd ventricle, Velum interpositum, lateral ventricle,
topographical positions ofsurface and deep structures Cisterna tecti, Lobulus quadrangularis cerebelli, to
can be made discernable. For these reasons, it is name just a few. Before such operations, it is advis
advisable to view the surface structures ofthe brain in able (the authorstilldoesso occasionally) toorientate
relationship to the skull, but then to start with re oneself on a formaldehyde-preserved brain. It is
movingthe bloodvessels andleptomeninges so thatin shown how on a formaldehyde-preserved brain, even
this way the skeletonized organ is dissected step by though itdoes not provide the realconditionsofalive
step, because in the preserved vascular system, the brain under the operative microscope, the most im
structures are only partially recognizable and thus portant topographical relationships can be recog
confusing. For this dissection two organs are needed. nized.
In the first dissection, the cerebrum and cerebellum Both volumes are the result of a one-year dissection
are studied. These the young neurosurgeon should course for colleagues meeting twice a week in our
have become familiar during his initial training in the clinic. The specimens depicted originate from these
surgeryofsurfacestructures. In the seconddissection, disse~tions or from the author himself.
the relationship between deep-seated parts, the ven In order to achieve as true and lifelike as possible a
tricular system and surface structures are of major representation, certain specimens were chosen and
importance. photographed in various positions by my colleague
Experience has shown that during such a dissection Priv.-Doz. Dr. H. R. Eggert. Slides of these photo
for thefirst timeseveralmistakes are madesothat the graphs were projected and then the author copied
specimen is rather damaged by the end of the dissec them in India ink, whereby the essential structures
tion, the deeper structures should be more carefully were brought out more clearly and others were left
studied during the second dissection. During the sec out. The authoralso thanks Priv.-Doz. Dr. H. R. Eg
ond dissection, the vessels and the leptomeninges can gert for several suggestions on presention and dissec
be preserved, not just on the outer surface of the tion techniques.
~brain but also especially in their depth so that the Special appreciation is due to Prof. Dr.
anatomical structure of the Velum interpositum be J. Staubesand, Directorofthe Institute ofAnatomy I
tween the Thalami and Fornices, the structure of the ofthe University ofFreiburg, and Prof. Dr. B. Volk,
VIII &...1 1PREFACE
---1
Director of the Institute of Neuropathology of the sible for a portion of the translation. The manuscript
University ofFreiburg, for their advice and help. For was typed by Mrs. T. Masyk and Mr. G. Forster.
her help in assembling and arranging of the material Finally, I wish to express my appreciation to the
and especially for her corrections of the text, special Springer Publishing Company for their invariably
thanks are due to my secretary for many years, courteous cooperation over the years and for the
Mrs. Ermy Hilsenbek-Hottek. Mrs. K. Weigand, of excellent layout of the books.
Linden by Giessen and H. H. Gossman, M. B.,
B. S., F. R. C. S., Plymouth/Devonshire are respon- Freiburg, June 1987 WolfgangSeeger
CONTENTS IX
L-J ----11
Contents
Part I
Anatomical Dissection of the Brain After Removal of Leptomeninges and Vessels
(Figs. 1 to 57)
Chapter 1
Basic Principles
(Figs. 1 to 5) 2
Chapter 2
Lateral and Medial Cortex cerebri
(Figs. 6 to 22) 12
Chapter 3
Basal Ganglia, Lateral and 3rd Ventricle
(Figs. 23 to 32) 46
Chapter 4
Cerebellum and 4th Ventricle
(Figs. 33 to 57) 66
Part II
Anatomical Dissection of the Brain. Leptomeninges and Vessels
Preserved (Figs. 58 to 150)
Chapter 5
Supratentorial Structures
(Figs. 58 to 134) 118
Chapter 6
Infratentorial Structures
(Figs. 135 to 150) 272
References 305
Subject Index 311
Part I
Anatomical Dissection of the
Brain After Removal of
Leptomeninges and Vessels
(Figs. 1 to 57)
'-
BASIC PRINCIPLES ....JJ 2
LI
Chapter 1
Basic Principles
(Figs. 1 to 5)
Fig. 1
A to 8' Most important instruments for anatomical
dissection
D to I Special instruments
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