Skip to main content Accessibility help
×
Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-28T01:57:40.207Z Has data issue: false hasContentIssue false

Chapter 3 - Vascularization of the Insula: Key Points for Safe Epilepsy Surgery

from Section 1 - The Human Insula from an Epileptological Standpoint

Published online by Cambridge University Press:  09 June 2022

Dang Nguyen
Affiliation:
Université de Montréal
Jean Isnard
Affiliation:
Claude Bernard University Lyon
Philippe Kahane
Affiliation:
Grenoble-Alpes University Hospital
Get access

Summary

The importance of the insula in focal epilepsy is increasingly being recognized. As such, surgical procedures involving the insula and their associated risks, especially vascular complications, are under investigation. Understanding of vascularization of the insula is essential for performing safe and accurate surgical treatment. This chapter summarizes the vascularization of the insula and related structures, including the M1, M2, and M3 segments of the middle cerebral artery, lenticulostriate artery, and long insular artery (LIA). The LIA is especially important to identify to avoid a white matter motor tract infarction during insular surgery. In addition, the venous system of the insula is described.

Type
Chapter
Information
Insular Epilepsies , pp. 26 - 30
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Tanriover, N, Rhoton, AL Jr., Kawashima, M, Ulm, AJ, Yasuda, A. Microsurgical anatomy of the insula and the Sylvian fissure. J Neurosurg 2004;100(5):891922.Google Scholar
Türe, U, Yaşargil, MG, Al-Mefty, O, Yaşargil, DC. Arteries of the insula. J Neurosurg 2000;92(4):676687.CrossRefGoogle ScholarPubMed
Delion, M, Mercier, P, Brassier, G. Arteries and veins of the Sylvian fissure and insula: Microsurgical anatomy. Adv Tech Stand Neurosurg 2016;(43):185216.CrossRefGoogle Scholar
Tanriover, N, Kawashima, M, Rhoton, AL Jr, Ulm, AJ, Mericle, RA. Microsurgical anatomy of the early branches of the middle cerebral artery: Morphometric analysis and classification with angiographic correlation. J Neurosurg 2003;98(6):12771290.CrossRefGoogle ScholarPubMed
Marinkovic, S, Gibo, H, Milisavljevic, M, Cetkovic, M. Anatomic and clinical correlations of the lenticulostriate arteries. Clin Anat 2001;14(3):190195.CrossRefGoogle ScholarPubMed
Djulejić, V, Marinković, S, Maliković, A, Jovanović, I, Djordjević, D, Cetković, M, et al. Morphometric analysis, region of supply and microanatomy of the lenticulostriate arteries and their clinical significance. J Clin Neurosci 2012;19(10):14161421.CrossRefGoogle ScholarPubMed
Rosner, SS, Rhoton, AL Jr., Ono, M, Barry, M. Microsurgical anatomy of the anterior perforating arteries. J Neurosurg 1984;61(3):468485.Google Scholar
Lang, FF, NE, Olansen, DeMonte, F, ZL, Gokaslan, EC, Holland, Kalhorn, C, et al. Surgical resection of intrinsic insular tumors: complication avoidance. J Neurosurg 2001;95(4):638650.CrossRefGoogle ScholarPubMed
Ikegaya, N, Takahashi, A, Kaido, T, Kaneko, Y, Iwasaki, M, Kawahara, N, et al. Surgical strategy to avoid ischemic complications of the pyramidal tract in resective epilepsy surgery of the insula: Technical case report. J Neurosurg 2018;128(4):11731177.Google Scholar
Jobst, BC, Gonzalez-Martinez, J, Isnard, J, Kahane, P, Lacuey, N, Lahtoo, SD, et al. The insula and its epilepsies. Epilepsy Curr 2019;19(1):1121.Google Scholar
Kumabe, T, Higano, S, Takahashi, S, Tominaga, T. Ischemic complications associated with resection of opercular glioma. J Neurosurg 2007;106(2):263269.Google Scholar
Tamura, A, Kasai, T, Akazawa, K, Nagakane, Y, Yoshida, T, Fujiwara, Y, et al. Long insular artery infarction: Characteristics of a previously unrecognized entity. AJNR Am J Neuroradiol 2014;35(3):466471.CrossRefGoogle ScholarPubMed
Delion, M, Mercier, P. Microanatomical study of the insular perforating arteries. Acta Neurochir (Wien) 2014;156(10):1991–1997; discussion 1997–1998.Google Scholar
Finet, P, Nguyen, DK, Bouthillier, A. Vascular consequences of operculoinsular corticectomy for refractory epilepsy. J Neurosurg 2015;122(6):12931298.CrossRefGoogle ScholarPubMed
Iwasaki, M, Kumabe, T, Saito, R, Kanamori, M, Yamashita, Y, Sonoda, Y, et al. Preservation of the long insular artery to prevent postoperative motor deficits after resection of insulo-opercular glioma: technical case reports. Neurol Med Chir (Tokyo) 2014;54(4):321326.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×