ArticleNeurosurgical review2025
Supracerebellar-supratrochlear and supracerebellar-infratrochlear triangles as gateways to the posterolateral midbrain and ambient cistern: descriptive and quantitative analysis of microsurgical anatomy.
Article in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Rho-associated kinase inhibitors in cerebral cavernous malformations: a preclinical systematic review.Neurosurgical review · 2026Pooled it
- Subtonsillar and vallecular triangles as gateways to dorsal brainstem and fourth ventricle lesions: descriptive and quantitative analysis of microsurgical anatomy.Neurosurgical review · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAnatomic triangles aid neurosurgeons in accessing deep targets. However, the supracerebellar-supratrochlear triangle (STT) and supracerebellar-infratrochlear triangle (ITT), defined by specific landmarks, remain underexplored. This study provides a descriptive and quantitative analysis of their anatomical parameters to enhance microsurgical utility.
methodsThe lateral supracerebellar-infratentorial (SCIT) approach with a retrosigmoid craniotomy was performed on 5 formalin-fixed, latex-injected, cadaveric heads, with STT and ITT identified bilaterally. Measurements were acquired using neuronavigation. Three additional cadaver brains were used to illustrate pertinent brainstem anatomy. Three-dimensional modeling and diffusion tractography visualized associated structures and fiber tracts.
resultsThe longest edges of the STT and ITT are the inferior edges, formed by the trochlear nerve and quadrangular lobule, respectively (mean [SD], 15.8 [2.0] mm and 29.4 [2.8] mm, respectively). Full expansion of retractable edges increased the area of the STT from 80.6 [15.5] mm² to 159.5 [25.5] mm² and the area of the ITT from 81.1 [28.6] mm² to 244.7 [57.9] mm². The STT provides access to the quadrigeminal cistern, posterior tegmentum, and P2P and P3 segments of the posterior cerebral artery. The ITT grants access to the ambient cistern, cerebellomesencephalic fissure, anterior tegmentum, S3 segments of the superior cerebellar artery, and lateral mesencephalic vein.
conclusionsAlthough the paramedian SCIT approach also reaches the posterolateral midbrain and ambient cistern, the lateral SCIT was preferred in this study because it also provides ideal access. With these approaches, the STT and ITT are secure and expandable anatomical corridors, facilitating access to intrinsic brainstem lesions, including tumors and vascular malformations.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.