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Surgical and Radiologic Anatomy
Published in: Surgical and Radiologic Anatomy 7/2018

01-07-2018 | Original Article

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

Authors: Satoshi Tsutsumi, Juan Carlos Fernandez-Miranda, Hisato Ishii, Hideo Ono, Yukimasa Yasumoto

Published in: Surgical and Radiologic Anatomy | Issue 7/2018

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Abstract

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.
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Metadata
Title
Dorsal extensions of the fastigium cerebelli: an anatomical study using magnetic resonance imaging
Authors
Satoshi Tsutsumi
Juan Carlos Fernandez-Miranda
Hisato Ishii
Hideo Ono
Yukimasa Yasumoto
Publication date
01-07-2018
Publisher
Springer Paris
Published in
Surgical and Radiologic Anatomy / Issue 7/2018
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-018-2023-3

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