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Is the distance between mammillary bodies predictive of a thickened third ventricle floor? Clinical article (94 visite)

Iaccarino C, Tedeschi E, Rapanà A, Massarelli I, Belfiore G, Quarantelli M, Bellotti A

J Neurosurg (ISSN: 0022-3085), 2009; 110(5): 852-857.

Tipo di articolo: Journal Article,

Impact factor: 2.594

Impact factor a 5 anni: 2.904

Parole chiave: Endoscopic Third Ventriculostomy, Intermammillary Distance, Mammillary Body, Neuroendoscopic Anatomy, Third Ventricle Floor, Adult, Aged, Anastomosis, Anatomical Variation, Anthropometric Parameters, Article, Brain Atrophy, Brain Third Ventricle, Clinical Article, Controlled Study, Endoscopic Surgery, Female, Human, Hydrocephalus, Image Analysis, Intraoperative Period, Neuroimaging, Nuclear Magnetic Resonance Imaging, Prediction, Preoperative Period, Priority Journal, Split Brain, Surgical Anatomy, Adolescent, Brain Ventricle, Child, Comparative Study, Middle Aged, Pathology, Preschool Child, 80 And Over, Cerebral Ventricles, Mamillary Bodies,

Url: http://www.scopus.com/inward/record.url?eid=2-s2.0-66849111932&partnerID=40&md5=360602a900a1fa41bf34ce5ea0743f29

Object. The aim of this study was to correlate intraoperative endoscopic third ventriculostomy (ETV) findings in hydrocephalic patients with the MR imaging appearance of the mammillary bodies (MBs), the fundamental anatomical landmarks of the third ventricle floor (TVF) region. Methods. The authors reviewed brain MR images and intraoperative ETV records in 23 patients with hydrocephalus as well as MR imaging data from 120 randomized control volunteers of various ages to define the normal intermammillary distance (IMD). Results. In control volunteers, no measurable IMD ("kissing" configuration) was observed in 91 (85%) of 107 cases, and there was mild MB splitting (mean ± standard deviation, 0.18 ± 0.12 cm) in only 16 cases with age-related cerebral atrophy. Among the 21 patients with complete MR imaging and ETV data sets, 12 ETV procedures were hindered by anatomical anomalies such as a thickened TVF or an "upward ballooning" phenomenon. On preoperative MR imaging in these 12 patients, there was an increased IMD (0.55 ± 0.41 cm) compared with that in the remaining 9 patients (0.27 ± 0.25 cm) who had a normal thin TVF during ETV and in the control group (0.03 ± 0.08 cm). Magnetic resonance imaging and ETV data concordantly displayed nonsplit MBs in 6 of 9 cases with a thin TVF and split MBs in 10 of 12 cases with a thick TVF. Conclusions. The normal configuration of MBs is no measurable IMD, with mild splitting occurring in patients with age-related brain atrophy. In hydrocephalic patients, a thickened TVF was present almost exclusively with an increased IMD on preoperative MR imaging and separated MBs on endoscopic viewing. Large retrospective series are needed to confirm that a preoperative increased IMD is predictive of a thickened TVF during ETV.
*** IBB - CNR ***

Neurosurgery Unit, Department of Neurological Sciences, S. Anna and S. Sebastiano Hospital, Caserta, Italy

Neuroradiology Unit, Department of Diagnostic Imaging, S. Anna and S. Sebastiano Hospital, Caserta, Italy

Biostructure and Bioimaging Institute, National Research Council, Napoli, Italy

Hub and Spoke Neurosurgery Unit, Emergency Department, University Hospital of Parma, Viale Gramsci, 14, 43100, Parma, Italy
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Iaccarino C, Tedeschi E, Rapanà A, Massarelli I, Belfiore G, Quarantelli M, Bellotti A
* Is the distance between mammillary bodies predictive of a thickened third ventricle floor? (85 visite)
J Neurosurg (ISSN: 0022-3085), 2009 May; 110(5): 852-857.
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1 Records (1 escludendo Abstract e Conferenze).
Impact factor totale: 2.594 (2.594 escludendo Abstract e Conferenze).
Impact factor a 5 anni totale: 2.904 (2.904 escludendo Abstract e Conferenze).

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