Turkish Neurosurgery 2010 , Vol 20 , Num 1
Surface Anatomy of the Transverse Sinus for the Midline Infratentorial Supracerebellar Approach
Hikmet TURAN SUSLU1, Mustafa BOZBUGA2, Adnan OZTURK3, Kayihan SAHINOGLU4
1,2Dr. Lütfi Kırdar Kartal Education and Research Hospital, Neurosurgery, Istanbul, Turkey
3,4Istanbul University, Medical Faculty, Department of Anatomy, Turkey
AIM: Knowing the location of the transverse sinus in the midline supracerebellar infratentorial approach is important to prevent its inadvertent injury. The external landmarks of the occipital bone have been studied in this anatomic study in order to reveal their relationship with the transverse sinus.

MATERIAL and METHODS: Fifty-two dried skulls were used to study the relationship of the transverse sinus with various surface bone structures. The key bone surface structures identified in each specimen were the superior nuchal line, the inferior nuchal line, the inion, internal occipital protuberance, and the transverse sulcus.

RESULTS: The distance from the inion to the inferior nuchal line in specimens ranged from 12.7 mm to 37.7 mm. The distance from the inferior nuchal line to the midline foramen magnum in the specimens ranged from 19 mm to 34.75 mm. The width of the proximal transverse sulcus ranged from 2.6 mm to 10.16 mm with an average of 6.43 mm on the right side and 3.4 mm to 10.6 mm with an average of 6.15 mm on the left.

CONCLUSION: The first and most superior burr hole for midline supracerebellar infratentorial approach can be safely placed approximately 1 cm below the inferior nuchal line. Aburr hole in this localization will avoid the transverse sinus. Keywords : Supracerebellar infratentorial approach, Pineal tumor, Inferior nuchal line, Transverse sinus, Transvere sulcus

Corresponding author : Hikmet Turan Suslu, hikmets1972@yahoo.com