Microsurgical anatomy of parasellar subarachnoid space at norma and in subarachnoid hemorrhage
Introduction. the knowledge of normal and pathological anatomy of system of cerebrospinal fluid circulation, particularly the stereotactic anatomy of suprasellar subarachnoid hemorrhage, is the necessary condition for successful surgical manipulation at the base of cerebrum. Object. Examination of topographoanatomical relationship between structures of parasellar subarachnoid space in normal condition and in subarachnoid space, detection of variants of anatomical features of brain base leptomeninges influencing (facilitating or complicating) on arachnoid dissection of parasellar subarachnoid space. Material and methods. Research was conducted on 17 human brain macropreparation fixed in 10%-мformaldehyde solution: series of preparation cuts in frontal section (6 normal and 5 pathological preparation), in sagittal section (3 normal and 1 pathological preparation), and in angular section (1 normal and 1 pathological preparation) were performed. Further the microscopic examination of preparations using microscope « МБ С-10» and step-by-step microphotography of preparations using digital camera «lympus»were conducted. Results. We revealed the regularity of blood spreading after aneurysmal subarachnoid hemorrhage depending on aneurysm localization, described the variants of basal arachnoid placement at the region of medial parts of brain lateral cisterns influencing on the character of arachnoid dissection, described the variants of relationship between optical nerve and olfactory tract. Conclusion. Parasellar subarachnoid space in spite of changes after subarachnoid hemorrhage always remains one whole morphofunctional system. SAH character (localization, distribution, presence of intracerebral and/or intraventricular hemorrhages) depends not only on hemorrhage intensity, but also on its source localization in relation to parasellar subarachnoid space and depends on structural features of parasellar subarachnoid space itself.