Complex Surgical Cases of the Limbic System Sepehr Sani, Mustafa K Baskaya, Richard W Byrne
INDEX
Page numbers followed by f refer to figure.
A
Adult limbic system 1
Adult remnant of the hippocampus 2f
Alveus 2
Ambient cistern 18
Ammon's horn 1
Anaplastic astrocytoma 136
Anaplastic mixed oligoastrocytoma 136
Anterior choroidal artery 32, 47, 141
Anterior temporal lobectomy 35
Anterior temporal lobectomy with amygdalohip- pocampectomy 35
neocortical resection 35
positioning and equipment 35
resection of the hippocampus 45
resection of uncus and amygdala 38
Approaches to the mesial temporal lobe for epilepsy 26
surgical anatomy 26
Arachnoid villi 63
Arteriovenous fistulas (AVFs) 140
Arteriovenous malformations (AVMs) 71, 140
B
Bardeen chest 91
Basal ganglia 8
Basal vein of Rosenthal 34, 142
Brain mapping during surgery 107
epilepsy specific techniques in eloquent cortex 115
multiple subpial transections 115
responsive neurostimulation system 116
indications 107
integrating with functional imaging 108
preoperative preparation 108
anesthetic considerations 109
craniotomy considerations 110
equipment 109
preparations and positioning 110
stimulation mapping 110
stimulation pitfalls 114
subcortical stimulation mapping 114
surgical endpoints 114
Broca's area 107
C
Calcarine sulcus 88
Callosal sulcus 2f
Callosomarginal artery 100
Capillary telangiectasias 140
Central nervous system (CNS) 140
Choroidal fissure 31
Choroid plexus 18
Cingulate gliomas 136
Cingulate gyrus 2, 90, 99
surgical approaches 99
Cingulate gyrus tumors 130
anatomical classification and growth patterns 134
clinical features 134
histopathological characteristics 135
overview of anatomy 130
surgery 136
surgical approaches 136
surgical outcomes 136
Collateral sulci 57
Corpus callosum 2
Corticofugal fibers 88
Crura of fornix 4
Crus of the fornix 16
D
Deep venous drainage 143
Diagonal band of Broca 5
Diencephalon 1
E
Entorhinal cortex 48
F
Falx-occipital fissure 88
Fasciolar gyrus 33
Fimbria 1
Fimbriodentate fissure 4
Foramen of Monro 16, 33
Fornix 1
Frontoparietal lobes 6
Frontotemporal curvilinear incision 35
Fusiform gyrus 36
G
Giant limbic tumors 129
Grade I ganglioglioma 126
Grade II astrocytoma 126
Grade IV glioblastoma 126
Gyrus of Ebertaller 22
H
Habenula 8
Hemianopia 130
Heschl's gyrus 9, 72
Hippocampal fissure 1
Hippocampal tail 2
Hippocampus and the choroidal fissure 33
I
Indusium griseum 2, 33
Infralimbic gyrus 13
Insula 21
Internal carotid artery (ICA) 54
Internal cerebral veins 152
Intralimbic gyrus 30
L
Labbe and Sylvian veins 48
Lamina terminalis 142
Left anterosuperior insular low-grade glioma 75
history 75
surgery 76
Left frontal-cingulate grade II mixed olio-astrocytoma 100
history 100
surgery 100
Left insular-subfrontal low-grade glioma; combined transsylvian/subfrontal- transcortical approach 78
history 78
surgery 78
Left posterior insula cavernoma 82
history 82
surgery 84
Left uncus cavernous malformation 53
history 53
surgery 53
Lenticulostriate arteries 71
Level of limen insula 73
Limbic cavernous malformations 154
anatomic distribution 154
clinical features 154
surgery 155
surgical approaches and techniques 155
surgical outcomes 156
Limbic embryologic development 1
Limbic lobe 140
Limbic system 1
structure and development 1
amygdala 5
fornix and mammillary body 3
hippocampus 1
insula 5
parahippocampal gyrus 3
septal area 5
Limen insulae 13
Lingual gyrus 88
Low-grade glioma 32
M
Magnetoencephalography (MEG) 108
Malignant gliomas 136
Mammillary body 8
Mediobasal temporal tumors 123
clinical features 124
growth patterns and anatomical classifications 125
histopathological characteristics 126
overview of microsurgical anatomy 123
surgery 126
surgical approaches 126
surgical outcomes 129
Mesial pia 38
Mesial pia of the temporal horn 18
Metzenbaum scissors 93
Meyer's loop 33, 88, 146
Middle cerebral artery 54, 141
Mixed oligoastrocytoma 136
Motor evoked potential 100
N
Nasal cannula 110
Neocortical limbic structures 8
Neurolon sutures 93
O
Occipital interhemispheric approach 87
anatomy 87
contraindications 89
details of surgical approach 91
history 87
indications 89
risks and pitfalls 95
Occipitoparietal sulci 148
Occipitotectal fibers 17
Occipitotemporal gyrus 3
Ojemann cortical stimulator 111
Olfactory stria 5
Opaque arachnoid bands 152
P
Parahippocampal gyrus 31
Parietal-occipital sulcus 88
Pericallosal artery 100
Planum polare 9
Planum temporale 9
Postcentral gyrus 75
Posterior cerebral artery 141
Posterior communication (PCOA) artery 47
Posterior interhemispheric parafalx 148
Posterior pole of incisura 127
Q
Quadrantanopia 130
Quadrigeminal cistern 65, 95, 152
Quadrigeminal segment 142
R
Responsive neurostimulation system (RNS) 116
Right-sided amygdala and hippocampus low grade glioma 48
history 48
surgery 51
Ringer's solution 109
Root of the zygoma 35
S
Schramm's series 126
Selective amygdalohip- pocampectomy 45
Sensorimotor stimulation 111
Septal nuclei 5, 8
Somatosensory cortex 111
Somatosensory evoked potential 100
Spetzler-Martin (SM) grading system 145
Splenium of the corpus callosum 88
Spontaneous hemorrhage 151
Stein's anatomical classification 148
Subcortical stimulation mapping (SSM) 114
Superior insular sulcus 21
Superior temporal gyrus 36
Supracerebellar transtentorial approach 57
anatomy 57
gross anatomy 57
vascular anatomy 58
contraindications 60
description of the approach 60
closure 69
dural opening and dissection 63
incision and craniotomy 61
preoperative evaluation and positioning 60
history 57
indications 58
risks and pitfalls 69
Supramarginal gyrus 73
Surgery for giant and unusual tumors 120
Surgery for vascular malformations of the limbic system 140
anatomical classifications 144
arteriovenous malformations 143
cavernous malformations 153
clinical features 145
surgical approaches 145
calloso-cingulate arteriovenous malformations 148
mediobasal temporal arteriovenous malformations 145
parasplenial arteriovenous malformations 148
surgical considerations 149
surgical outcomes 153
vascular anatomy of the limbic system 140
calloso-cingular area 142
mediobasal temporal region 141
Surgical anatomy of the insula 71
insular anatomy 72
operative approach 74
Sylvian fissure 21, 111
Sylvian fissure and opercular anatomy 24
T
Telencephalon 1
Temporal lobe 6, 9, 73
anatomy 9
amygdala 13
hippocampus 15
mesial surface 11
superior surface 9
temporal horn and choroidal fissure 17
uncus 11
histology 9
vascular relationships 18
anterior choroidal artery 19
internal carotid artery 18
middle cerebral artery 20
posterior cerebral artery 19
posterior communicating artery 18
Temporal stem 73
Tentorial incisura 58
Transcranial magnetic stimulation (TMS) 108
Transsylvian approach to amygdalohippocam- pectomy 47
Tumor resection in the anterior temporal lobe 47
U
Uncal gyrus 38
Uncal recess 47
Uncinate fasciculus 48
Uncohippocampal artery 142
Uncus and amygdala 32
V
Vagus nerve stimulation (VNS) 116
Vascular clips 63
Vein of Galen 58
Vein of Labbé 36, 65
Velum terminale 30
Venous anatomy 65
Vertex of the gyrus 116
Visual field defects (VFD) 153
W
Wernicke's area 107
Y
Yasargil's series 126
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