Lateral ventricle n copy

Lateral ventricle neuroanatomy and relations with other structures of brain

1. Lateral ventricle Dr Abhishek Rai DNB Neurosurgery

2. Learning points Introduction Historical overview Development and embryology Anatomy Neural relationship Relation with cortical sulci Relationship with white matter fasicles

3. Introduction

4. Historical overview Aristotle (384-322 BC) was perhaps the first person to report the existence of brain cavities, particularly those located in each cerebral hemisphere. Herophilos of Chalcedon (335-280 BC) first time identified and described such ventricles and choroid vesicles. Erasistratus of Ceos (304-250 BC), a disciple of Herophilus , proposed the ventricular theory He stated that spiritus vitalis , found in the blood, extended from the heart to the brain controls structure-function relationships. Rufus of Ephesus, teacher of Galen of Pergamum, detailed the lateral ventricles -the third and fourth ventricles- and the mesencephalic aqueduct

5. Historical overview Galen (130-200) described this ventricular system with detail and believed seizures were originated by the obstruction of the exit of the cerebral ventricles. Galen not only provided a correct view of the morphology of the four ventricles also described as mental faculties were located in the solid portions of the brain. Leonardo da Vinci (1452-1519)

6. Historical overview Andreas Vesalius (1514-1564), came to conclusions that contradicted established galenic dogmas by means of dissections made in executed criminals. Ventricles filled with CSF. Thomas Willis (1621-1675), proposed that CSF originated in the choroid plexus. Alexander Monro secundus (1733–1817), Scottish physician, recorded detailed descriptions and illustrations regarding the communication between the lateral and third ventricles of the brain as well as describing changes seen in hydrocephalus also proposed Monro -Kellie hypothesis.

7. bjb Development

8. Development

9. Development

10. bjb Development

11. Each lateral ventricle is a C-shaped cavity having around 10 cc of csf,it wraps around the thalamus and is situated deep within the cerebrum. Each lateral ventricle has five parts: A frontal horn which has a ventral extremity in front of the interventricular foramen (IVF). Its length is approximately 6 cm A body between IVF and atrium A temporal horn or inferior horn or sphenoidal horn, whose length is 4 cm An atrium between these different parts The occipital horns Anatomy

12. All five parts of lateral ventricle has medial and lateral walls, a roof, and a floor. In addition, the frontal and temporal horns and the atrium have anterior walls. Thalamus Caudate nucleus Fornix Corpus callosum Septum pellucidum Internal capsule Neural Relationships

13. . Neural Relationships

14. The anterior frontal horn The boundaries are: Internal wall : septum pellucidum Roof, anterior wall and floor : anterior wrapping of the corpus callosum, genu, rostrum and trunk lateral wall: internal aspect of the head of the caudate nucleus.

15. The body of Lateral ventricles The boundaries are: Internal wall: Septum pellucidum and body of fornix Roof : Inferior aspect of the body of corpus callosum Lateral wall : Medial part of the body of the caudate nucleus Floor: Supero-medial aspect of thalamus

16. The atrium It communicates Cranially , ventrally and medially with the frontal horn. Dorsally : the Occipital horn C audally , ventrally and laterally with the inferior horn . Anterior wall : Pulvinar Roof and posteriorly : Splenial fibres Medial wall : The choroidal fissura with the choroidal plexus (glomus )

17. The occipital horn The boundaries are: Cranially and inferiorly : by the fibers of the splenium ( bulbar prominence ) and the deep part of the calcarine sulcus (calcar alvis ) Floor : Bulge by the collateral sulcus forming the collateral eminence Lateral wall: white matter of the tapetum , overlaid laterally by the optic radiations and then the inferior longitudinal fasciculus

18. The temporal horn The boundaries are: Floor : pes hippocampus and caudally the collateral eminence Roof : inferior aspect of the thalamus , tail of the caudate nucleus and deep white matter of the temporal lobe Internal wall : Choroidal fissura and choroid plexus

19. The interventricular foramen The boundaries are: Laterally : The anterior pole of the thalamus Ventrally : The anterior crus fornicis . Diameter : 3–4 mm

20. Choroid plexus and CSF circulation It courses within the body, the atrium and the temporal horn. At level of the atrium, it is bulky and often presents with calcifications or cysts: it’s the choroidal glomus.

21. Arterial vasculature Anterior choroid artery ( AChA ): optic tract , the cerebral peduncle the globus pallidus , the origin of the optic radiations . Posterior choroid artery ( PChA ) : Medial PChA : Lateral : peduncle, fornix, pulvinar and caudate nucleus.

22. Veins of the lateral ventricles Veins of the medial wall of the LV: Anterior septal vein Posterior septal veins draining into the ICV. Medial atrial veins joining either the lateral atrial vein or the ICV or the medial occipital vein Transversal veins of the hippocampus draining into the basal vein or the ICV. Vein of the amygdaloid body

23. Veins of the lateral ventricles Veins of the lateral wall: Anterior caudate veins draining into the thalamostriate vein. Thalamostriate vein Posterior caudate veins Thalamocaudate vein joins the ICV before the atrium. Lateral atrial veins ending in the vein of Galen Inferior ventricular veins

24. Relationships with the cortical sulci(Anatomical) C alcarine sulcus forms the calcar alvis on the medial wall of the occipital horn. Collateral sulcus forms the collateral eminence on the floor of the temporal horn, of the atrium and of the occipital horn. The hippocampal sulcus raises on the medial wall of the temporal horn and forms the horn of Ammon.

25. Relationships with the cortical sulci Longitudinal fissure of the brain(interhemispheric fissure) T1–T2 sulcus The sulcus lateralis (scissure of Sylvius)

26. Relationships with white matter fascicles Association fasciculi : Fornix Comissural fibres : Corpus callosum Projection fascicles : Auditory radiations Optic radiations

27. Relationship with Cortical eloquent areas

28. Distances between cortex and ventricular cavity

29. Distances between cortex and ventricular cavity Here are the average values from the literature: Frontal cortex - ivf maximum 60mm Frontal cortex – frontal horn: 35–40mm Temporal cortex – temporal horn: 25–30mm Cortex of the hemispheric cross-road – atrium: 30mm Parietal cortex – atrium: 50mm Occipital cortex – atrium: 55mm