Türk Nöroşirürji Dergisi 2020 , Vol 30 , Num 1
Microsurgical White Matter Anatomy of the Hypothalamus and Surgical Approaches to the Hypothalamus
Pelin KUZUCU1,Abuzer GÜNGÖR2,M. Necmettin PAMİR2
1Gazi Üniversitesi, Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, Ankara, Türkiye
2Acıbadem Mehmet Ali Aydınlar Üniversitesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, İstanbul, Türkiye
Although the hypothalamus has a mixed anatomic structure and a large number of functions, the white matter pathways it is associated with have not yet been fully understood. Therefore, knowing the associated white matter pathways within the anatomical boundaries makes the results more successful during surgical approaches to the hypothalamus. Considering the related white matter pathways of the anatomy of the hypothalamus; the diagonal band of Broca, ventral amygdalohypothalamic fiber, stria terminalis, fornix, and the postcommissural fornix are related to the anteromedial part of the hypothalamus; the cingulum, supraoptic commissure, and the frontopontine tracts are related to the anterolateral part of hypothalamus; the medial longitudinal fasciculus and the dorsal longitudinal fasciculus are related to the posteromedial part of the hypothalamus; the ansa peduncularis, the postcommissural fornix, the fasciculus mamillaris princeps, the corticospinal tract, the temporo-parieto-occipito-pontine tract, the medial lemniscus, the spinothalamic tract, the mammillotegmental tract and the dentatorubrothalamic tract are related to the posterolateral part of the hypothalamus; and the fasciculus retroflexus and mammillothalamic tract lie superoinferior part of the hypothalamus. Endoscopic, supraorbital, subfrontal, pterional, orbitozygomatic transcallosal and transcortical transventricular, and the transsphenoidal methods can be used for surgical approaches to this important region. In addition, it is possible to obtain effective surgical results by knowing the present anatomical structure of the hypothalamus, which is becoming a target in DBS surgery. Anahtar Kelimeler : Brainstem, Deep brain stimulation, Hypothalamus, Fiber dissection, White matter pathways