The cerebral ventricles have been recognized since ancient medical history. Their true function started to be realized more than a thousand years later. Their anatomy and function are extremely important in the neurosurgical panorama. The literature was searched for articles and textbooks of different topics related to the history, anatomy, physiology, histology, embryology and surgical considerations of the brain ventricles. Herein, we summarize the literature about the cerebral ventricular system.

The ventricular system of the brain: a comprehensive review of its history, anatomy, histology, embryology, and surgical considerations

Background: The carotid arterial system which consists of right and left common carotid arteries is the main arterial supply of the head and neck. Studies show that variations exist to the level of bifurcation of the common carotid artery. Knowledge of these variations is of importance for surgical approaches in the head and neck region, such as carotid endarterectomy, radical neck dissection, catheterization etc, thereby reduce the risk of operative morbidity and mortality in patients undergoing operations, involving the common carotid artery.
Objective: The main purpose of the study was to assess height of the common carotid artery bifurcation in relation to the cervical vertebrae.
Method: Observational based descriptive study was conducted on thirteen human preserved cadavers, which were obtained from the departments of human anatomy, Colleges of Medicine and Health Sciences, Gondar and Bahirdar Universities and Gamby College of Medical Sciences–Bahirdar after the approval of the ethical committee.
Results: The bifurcation of the common carotid artery was found high in 12 (46.15%) of the cases among which the most common levels of bifurcation was at the level of C3 (42.3%). 14 (53.85%) of the cases was standard of which C4 (38.4%) was the most common and low bifurcation was not found. It was also found that in 61.5% of the cases the carotid bifurcation was asymmetrical between the right and left sides.
Conclusions: The present study showed that standard level of bifurcations was found to be more common than high level and low bifurcation was not found. The level of bifurcation was generally asymmetrical between right and left sides. Thus anatomical knowledge of the variability of carotid bifurcation levels will be useful for clinicians, to avoid unnecessary complications.

https://www.longdom.org/open-access/anatomical-variations-of-the-common-carotid-artery-bifurcations-in-relation-to-the-cervical-vertebrae-in-ethiopia-2161-0940.1000143.pdf

Anatomical Variations of the Common Carotid Artery Bifurcations in Relation to the Cervical Vertebrae in Ethiopia

The purpose of this manuscript is to add some more information in the present scientific literature on these nearly forgotten triangles of surgical importance. The neck is an area that lends itself to anatomical geometry, such as triangles. Many triangles of the neck have been described, and some are well-known, yet, some have been nearly forgotten, i.e., Lesser's triangle, Farabeuf triangle, Pirogoff's triangle, and Beclard's triangle. From the anatomic and surgical point of view, the neck is an amazingly interesting place. It is like a connection where crucial functional units meet and pass. Added surgical landmarks are always helpful to the surgeon while dealing with the neck. Described triangles of neck in this article are always reliable and constant landmarks for head and neck surgeons.

Forgotten triangles of neck.

Objective: Carotid bifurcation (CB) and its terminal branches are the most common sites of atherosclerotic plaques. In surgical treatment, these plaques can be reached by an endarterectomy technique. The success of the technique can be achieved with good anatomical knowledge of these arteries and their relationships with surrounding structures. Materials and methods: The study was performed retrospectively on archived images of patients with computed tomography angiography (CTA). Two hundred forty-seven patients who met the criteria were included in this study. Three-dimensional (3D) reconstructions of two-dimensional CTA images were made automatically using the open-source software Horos v.4.0.0. The distance between the transverse plane passing through the bifurcation point (BP) and the defined planes of the surrounding structures was evaluated. Results: CB was observed below the mastoid process, gonion point, and hyoid bone. CB was observed above the thyroid cartilage. Carotid bifurcation was seen at 15 levels in total, the lowest in the upper 1/3 of the C6 vertebral body and the highest in the lower 1/3 of the C2 vertebral body. In all cases, the most common level was the C3 lower level. Conclusion: All these values, which emerged as a result of the study, provide general information about the topography of the CB according to the neighboring structures. Estimating the location of the CB according to the gonion and hyoid bone will give a more accurate result. The vertebral level on the right side increased in direct proportion to age; there was no similar relationship on the left side. It is necessary to be aware of these anatomical variations in order to prevent various iatrogenic complications.

/pdf/topography-of-the-anatomical-landmarks-of-carotid-135w0d25.pdf

Topography of the Anatomical Landmarks of Carotid Bifurcation and Clinical Significance

Introduction: The carotid arterial system which begins from the common carotid arteries (CCAs) is the main arterial supply of the head and neck. The knowledge of point of bifurcation of CCA is very important in surgeries of head and neck region to prevent vascular accidents, during catheterization of carotid arteries and intra-arterial administration of chemotherapeutic agents. The carotid arteries lying anterolaterally in the neck are the major structures commonly injured in penetrating wounds of the neck Hence this study to evaluate the variations, levels of divisions among both male and female cadavers in Local Medical Teaching Institutes. Methods: This Observational based descriptive study design was conducted to describe the CCA bifurcation. Study was undertaken in 30 adult formalin fixed cadavers The dissections were carried out according to the instructions given in Cunningham’s manual of practical anatomy . The level of bifurcation of common carotid artery was noted and correlated with the upper border of thyroid cartilage. The age of death ranged from 24 to 78 years and all specimens were fixed in 10% formaldehyde solution. Result: A total of thirty unclaimed adult cadavers of 3 females and 27 males or 60 specimens (30 cadavers, left and right sides). The height of cadavers ranges from 154 cm – 180 cm.The level of bifurcation of the common carotid artery was at the level of upper border of thyroid cartilage in 78.33%. Only 11.66%) showed the higher level . 10 % showed the lower level of bifurcation in the range of 2 mm to 10 mm below the level of upper border of thyroid cartilage. The bifurcation levels were symmetrical on both sides. Conclusion: The present study finds the incidence of bifurcation of common carotid was more or less constant at the level of upper border of thyroid cartilage. Clinicians / Surgeons need to take the standard and variable heights of the carotid bifurcation into consideration; to avoid unnecessary complications.

/pdf/an-observational-study-about-the-levels-of-bifurcations-in-24sa5wqzx8.pdf

An Observational study about the levels of bifurcations in Common Carotid Artery among male & female cadavers

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 Surgical landmarks for application during surgery of the neck may be useful to the neurosurgeon. The present study was performed to explore the utility of a nearly forgotten anatomical triangle of the neck, the triangle of Farabeuf (TF) formed by the common facial and internal jugular veins and the hypoglossal nerve as its base directly superiorly. This study was carried out on 12 (24 sides) formaldehyde-fixed adult human cadavers (5 males and 7 female. The presence of TF was documented and measurements made of its sides. Additionally, structures found within the triangle were observed. TF was present on 15 sides and absent on 5 sides. The TF, when present, contained at least the proximal internal or external carotid artery in 14 of the 15 sides (93.3%), and both in 6 of the sides (40%). The carotid bifurcation was present in the triangle on 2 sides (13.3%) and was located inferior to the TF in the other cases. A jugulodigastric node was found in the TF on 8 sides (33%). The mean length of the TF for inferior, superior and posterior legs of the triangle was 1.05 cm, 1.58 cm, and 1.92 cm, respectively. We found that the proximal common facial vein was up to 2 cm superior to or 1.5 cm inferior to the common carotid artery bifurcation. Knowledge of the TF may be of use to the surgeon during procedures of the neck such as placement of ventriculoatrial shunts into the common facial vein or neurotization procedures utilizing the hypoglossal nerve. Carotid endarterectomy may be performed by traversing the TF to access the proximal internal carotid artery.

Use of the Triangle of Farabeuf for Neurovascular Procedures of the Neck

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Use of the Triangle of Farabeuf for Neurovascular Procedures of the Neck