Neurocirugía Neurocirugía
Neurocirugia.1997;8:163-70 - Vol. 8 Núm.3 DOI: 10.1016/S1130-1473(97)71026-1
Anatomía quirúrgica de la porción cisternal del IV par craneal
Surgical anatomy of the cisternal segment of the trochlear nerve
E. Urculo Bareño
Sección de Neurocirugía. Hospital de Guipúzcoa. San Sebastián
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.

Summary

In this paper the author describes the results of an anatomical study of the cisternal segment of the trochlear nerve, performed on 10 adults cadavers. The anatomical aspects of surgical interest are emphasized in relation to the cisternal course of the 4 th cranial nerve, dividing it into two segments: an initial or cerebellomesencephalic segment and a distal or tentorial segmento

The long cisternal course of the trochlear nerve (35 s.d. 5mm), its arachnoidal attachments, its thinness (0.7–1mm thick) and its infratentorial position (in close relationship with the inner face of the tentorium cerebelli), are anatomical features that make it a potentially fragile nerve which may be inadvertently damaged during surgical manipulation to the region of the tentorial incisure, especially during transtentorial subtemporal approaches.

Key words
Cranial nerve, Trochlear nerve, Subtemporal transtentorial approach, Surgical anatomy
Palabras clave
Nervio craneal, Nervio troclear, Abordaje subtemporal transtentorial, Anatomía quirúrgica
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Urculo Bareño, E.: Anatomía quirúrgica de la porción cisternal del IV par craneal. Neurocirugía 1997; 8: 163–170.

Copyright © 1997. Sociedad Española de Neurocirugía
Neurocirugia.1997;8:163-70 - Vol. 8 Núm.3 DOI: 10.1016/S1130-1473(97)71026-1