Microvascular anatomy of the interpeduncular fossa

Abstract

An understanding of the microvascular anatomy of the midbrain and posterior diencephalon is essential in the surgical management of lesions in that region. A description of the arterial pattern of blood supply to these areas is the purpose of this study. Perforating branches originating from the last 5 mm of the basilar artery, from the initial 7 mm of both superior cerebellar arteries (SCA's), and from the initial segment (P1 segment) of the posterior cerebral artery were studied in 56 unfixed human cadaver brain hemispheres. The brains were injected with polyester resin. The perforating branches penetrated through a small space in the upper part of the interpeduncular fossa. The anterior two-thirds of this space was occupied by the posterior perforated substance (PPS), and the posterior one-third was the site of penetration of the branches that supply the inferior mesencephalon. The PPS was divided into anterior and posterior halves. The anterior half was perforated by the paramedian thalamic arteries (diameter 0.57 +/- 0.11 mm) while the superior paramedian mesencephalic arteries (diameter 0.20 +/- 0.06 mm) perforated the posterior half. The perforating arteries originated from a trunk exclusive to the anterior half in 30%, from a trunk supplying both halves in 57%, and from a trunk exclusive to the posterior half in 13% of specimens. There were 26 naturally occurring anastomoses between the perforating branches. The paramedian inferior mesencephalic arteries penetrating the posterior one-third of the upper part of the interpeduncular fossa arose from the P1 segment in 32% of the brains studied, from the proximal 7 mm of the SCA in 45%, and from the last 5 mm of the basilar artery in 23%.