This chapter explore the anatomy of the Lamina Terminalis,
the Cisterna Chiasmatica and its neurovascular relationships as seen in a
Zambian population and compare with the findings in the literature. The Lamina
Terminalis represents an important neuroanatomical structure by which third
Ventriculostomy could be performed into the subarachnoid space through the
Cisterna Chiasmatica. The Cisterna Chiasmatica is a dilatation of the
subarachnoid space which lies adjacent to the Optic Chiasma and filled with freely
circulating cerebral spinal fluid. Recent studies have indicated a role for
Lamina Terminalis fenestration in approaching pathologies of the third
ventricle. However, there is limited knowledge on the anatomical features,
variations and the vasculature of the Lamina Terminalis in a Zambian
population. The study was a descriptive cross-sectional design in which 32
post-mortem human cadaveric brains were systematically sampled. The Lamina
Terminalis region was examined in 27 male cadavers and five female cadavers of
age range between 25 and 66 years (mean 34.1 ± 9.2years). The Cisterna
Chiasmatica a dilated subarachnoid space was examined in particular with
neurovascular structures adjacent to the Lamina Terminalis. Data was collected
using a data collection form, entered and analyzed by descriptive statistics
using Statistical Package for Social Sciences (SPSS) software version 22. The
base of the brain was detached from the floor of the cranial cavity and the
Lamina Terminalis exposed fully by retracting both optic nerves and the optic
Chiasma posteroinferiorly. The triangular Lamina Terminalis measurements were
performed as the distance between the midportion of the upper aspect of the
chiasma and the lower aspect of the anterior commissure (height), which
averaged 8.6 ±1.0 mm. The distance between the medial edges of the optic tracts
(base) averaged ±1.1 mm and the area averaged 56.9 ± 11.6 mm2. The Lamina
Terminalis membrane showed variations in appearance; 20 were transparent with a
large dark midline gap and 10 were less translucent with a slender midline gap
and two were indistinct. The Cisterna Chiasmatica was observed as a dilated
subarachnoid space adjacent to the Optic Chiasma. For neurovascular
relationships, 24 cadavers showed arterioles arising from the posterosuperior
aspect of the anterior cerebral artery to perforate the anterior perforating
substance(s), supplying the chiasma, and optic tracts; whereas, eight cadavers
showed arterioles arising posteroinferiorly and ramifying on the Lamina Terminalis.
The Lamina Terminalis membrane is variably developed. There are variations in
the membrane appearance, measurements and neurovascular relationships. This
study suggests that routine examinations of the lamina terminalis is of great
importance in neurosurgeries of pathologies of the third ventricle. These
findings will supplement a knowledge gap in neuroanatomy and help prevent
complications during Lamina Terminalis fenestration in approaching pathologies
of the third ventricle.
Author(s) Details:
Vivienne Nambule Syamuleya,
Department of Anatomy, School of Medicine, University of Zambia
Lusaka, Zambia.
Isaac
Sing’ombe,
Department
of Anatomy, School of Medicine, University of Zambia Lusaka, Zambia.
Fridah Mutalife,
Department of Anatomy, School of Medicine, University of Zambia
Lusaka, Zambia.
Sikhanyiso Mutemwa,
Department of Anatomy, School of Medicine, University of Zambia
Lusaka, Zambia.
Elliot Kafumukache,
Department
of Anatomy, School of Medicine, University of Zambia Lusaka, Zambia.
Krikor
Erzingatsian,
Department
of Surgery and Anatomy, School of Medicine, University of Zambia, Lusaka,
Zambia.
Please see the link here: https://stm.bookpi.org/ANUMS-V7/article/view/13428
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