Dorsal extensions of the fastigium cerebelli: an anatomical study using magnetic resonance imaging.

Background and purpose: The fastigium cerebelli is an important topographical landmark for neurosurgeons and radiologists. However, few studies have characterized the morphology of the fastigium cerebelli. We aimed to investigate the fastigium cerebelli using postmortem specimens and magnetic resona...

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Published in:Surgical & Radiologic Anatomy Vol. 40; no. 7; pp. 829 - 835
Main Authors: Tsutsumi, Satoshi, Fernandez-Miranda, Juan Carlos, Ishii, Hisato, Ono, Hideo, Yasumoto, Yukimasa
Format: Journal Article
Published: Springer Nature Jul2018
Online Access:View this record in EBSCOhost
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      dt: Jul2018
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00276-018-2023-3
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        atl: Dorsal extensions of the fastigium cerebelli: an anatomical study using magnetic resonance imaging.
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        au:
          Tsutsumi, Satoshi
          Fernandez-Miranda, Juan Carlos
          Ishii, Hisato
          Ono, Hideo
          Yasumoto, Yukimasa
        affil: Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, 279-0021, Urayasu, Chiba, Japan
      sug:
      ab: Background and purpose: The fastigium cerebelli is an important topographical landmark for neurosurgeons and radiologists. However, few studies have characterized the morphology of the fastigium cerebelli. We aimed to investigate the fastigium cerebelli using postmortem specimens and magnetic resonance imaging (MRI) in vivo.Materials and methods: Three cadaveric brains were midsagittally sectioned for observing the fastigium cerebelli. Additionally, 66 outpatients underwent MRI, including sagittal T1-weighted imaging, axial T2-weighted imaging, and coronal constructive interference in steady-state (CISS) sequence.Results: In the cadaveric specimens, the fastigium cerebelli was observed as a beak-like dorsal protrusion of the fourth ventricle. Its inner surface was observed as a small fovea. On serial CISS images, the fastigium cerebelli consistently possessed a pair of triangular-shaped, dorsal extensions lying parasagittally along the nodule. These extensions were classified as symmetrical, right-side dominant, or left-side dominant. The symmetrical type was the most predominant and comprised 60.6% of the extensions, while the right-side dominant and left-side dominant types comprised 13.6 and 25.8%, respectively. In 91% of the 66 patients, the number of slices covering the entirety of the dorsal extensions were the same on both sides. The fastigial angle (θ) formed by lines tangent to the superior and inferior medullary velums varied widely.Conclusions: The fastigium cerebelli has a pair of dorsal extensions lying parasagittally along the nodule. Coronal CISS sequence is useful in delineating the fastigium cerebelli in vivo.
      pubtype: Academic Journal
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      ougenre: Article
    language: English
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