Spyridon Komaitis1,2,3, George Stranjalis4,5,6, Theodosis Kalamatianos6, Evangelos Drosos4,5,6, Aristotelis V Kalyvas4,7, Georgios P Skandalakis4,5,7, Evangelia Liouta5,6, Eirini Charalampopoulou4, Nektarios Mazarakis8, Christos Koutsarnakis4,5,9,6. 1. Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece. skom.med@googlemail.com. 2. Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece. skom.med@googlemail.com. 3. Hellenic Center for Neurosurgical Research, "Petros Kokkalis", Athens, Greece. skom.med@googlemail.com. 4. Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece. 5. Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece. 6. Hellenic Center for Neurosurgical Research, "Petros Kokkalis", Athens, Greece. 7. Division of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Canada. 8. Department of Neurosurgery, Leeds General Infirmary, Leeds, UK. 9. Edinburgh Microneurosurgery Education Laboratory, Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK.
Abstract
BACKGROUND: Three-dimensional relationships within the limbic and paralimbic areas are often hard to grasp. Relevant anatomical structures exhibit a complicated architecture and connectivity and therefore surgical approaches targeting lesions or functional resections in this area pose a distinct challenge. PURPOSE: To provide an educational, comprehensive, systematic and stepwise manual for the dissection and illustration of major limbic structures since there is a gap in the pertinent literature. Further, we aim to offer a thorough yet simplified roadmap for laboratory and intraoperative dissections. METHODS: Twenty (20) normal adult, formalin-fixed cerebral hemispheres were studied through the fiber dissection technique and under the microscope. Stepwise and in tandem medial to lateral and lateral to medial dissections were performed in all specimens aiming to reveal the morphology and spatial relationships of major limbic and paralimbic areas. RESULTS: Fourteen (14) consecutive, discrete and easily reproducible laboratory anatomical steps are systematically described to reveal the intricate anatomy of the limbic and paralimbic structures and their main connections. CONCLUSION: This study offers for the first time in the pertinent literature a focused, step-by-step laboratory manual for the dissection and illustration of the limbic and paralimbic structures. The overreaching goal is to supplement the novice and experienced anatomist and neurosurgeon with a thorough and systematic reference to facilitate laboratory or intraoperative dissections.
BACKGROUND: Three-dimensional relationships within the limbic and paralimbic areas are often hard to grasp. Relevant anatomical structures exhibit a complicated architecture and connectivity and therefore surgical approaches targeting lesions or functional resections in this area pose a distinct challenge. PURPOSE: To provide an educational, comprehensive, systematic and stepwise manual for the dissection and illustration of major limbic structures since there is a gap in the pertinent literature. Further, we aim to offer a thorough yet simplified roadmap for laboratory and intraoperative dissections. METHODS: Twenty (20) normal adult, formalin-fixed cerebral hemispheres were studied through the fiber dissection technique and under the microscope. Stepwise and in tandem medial to lateral and lateral to medial dissections were performed in all specimens aiming to reveal the morphology and spatial relationships of major limbic and paralimbic areas. RESULTS: Fourteen (14) consecutive, discrete and easily reproducible laboratory anatomical steps are systematically described to reveal the intricate anatomy of the limbic and paralimbic structures and their main connections. CONCLUSION: This study offers for the first time in the pertinent literature a focused, step-by-step laboratory manual for the dissection and illustration of the limbic and paralimbic structures. The overreaching goal is to supplement the novice and experienced anatomist and neurosurgeon with a thorough and systematic reference to facilitate laboratory or intraoperative dissections.