Neurocirugía Neurocirugía
Neurocirugia. 1997;08:163-70. - Vol. 08 Núm.03 DOI: 10.1016/S1130-1473(97)71026-1

Anatomía quirúrgica de la porción cisternal del IV par craneal

E. Urculo Bareñoa

a Sección de Neurocirugía. Hospital de Guipúzcoa. San Sebastián

Palabras clave

Nervio craneal. Nervio troclear. Abordaje subtemporal transtentorial. Anatomía quirúrgica.

Resumen

En este artículo se presentan los resultados de un estudio anatómico de la porción cisternal del nervio troclear, realizado sobre 10 cadáveres de adultos. Se destacan los aspectos anatómicos de interés quirúrgico en relación a la trayectoria cisternal del IV par craneal, dividiéndolo en dos segmentos: un segmento inicial o cerebelo-mesencefálico y un segmento distal o tentorial.

El largo recorrido cisternal del nervio troclear (35 s.d. 5mm), sus adherencias aracnoideas, su delgadez (0.7-1mm de grosor) y su localización infratentorial (en estrecha relación con la cara inferior de la tienda del cerebelo), son características anatómicas que le hacen ser un nervio potencialmente frágil y de inadvertida lesión durante las maniobras quirúrgicas de acceso a la amplia región de la incisura tentorial, especialmente durante los abordajes subtemporales transtentoriales.

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