Intracranial Anatomical Triangles [Neurosurgery Wiki]

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====== Intracranial Anatomical Triangles ======

see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5714398/#REF17

===== Cavernous sinus triangles =====

[[Cavernous sinus triangles]]


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see [[Oculomotor-tentorial triangle]].

Anterolateral triangle ([[Mullan's triangle]])



Posterolateral triangle ([[Glasscock triangle]]).

Posteromedial triangle ([[Kawase triangle]])

Inferomedial triangle (Dolenc): this triangle is formed by the apex of the
Posterior clinoid process, the dural entry point of nerve IV into the tentorium,
and the dural entry point of nerve VI 

Inferolateral (trigeminal) triangle: this triangle is defined by the dural entry
point of nerve IV into the tentorium (upper point), the entry point of nerve
VI into the dura of the clivus (medial point), and the entry point of the
petrosal vein into the SPS (lateral point).
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The [[posterior fossa tumor]]s can be situated either [[dorsal]] and [[lateral]], [[ventral]] and [[medial]], or occupying both [[region]]s in relation to the [[cranial nerve]]s, with the latter position being especially challenging. In an effort to organize neurovascular complexes contained within, anatomically based [[triangle]]s have been proposed to serve as guiding [[landmark]]s for locating critical neurovascular structures. The objectives of this study were to: (1) provide a review of historical anatomically based vascular-centric triangles of the [[posterior fossa]] based on respective neurovascular complexes; (2) introduce a more organized alternative system of triangles with the conceptualization of a projection system from superficial to deep; and (3) propose and describe two new triangles of the posterior fossa: [[Petrous-Acousticofacial triangle]] and [[Acousticofacial-Trigeminal triangle]]. Five [[cadaver]]s were studied. Neurovascular complexes were described with the use of anatomically guided cranial nerve-centric triangles, each of which was formed by cranial nerves, [[petrous bone]], [[brainstem]], [[tentorium]], and [[superior petrosal vein]]. All [[triangle]]s were measured and anatomical boundaries confirmed by [[neuronavigation]]. Two circumferential frameworks were created to correlate superficial and deep anatomy: (1) Outer circumference and (2) Inner circumference. Posterior fossa was divided into the following: (1) Superior complex-corresponds to the sub-[[asterion]]al region, which was projected to the [[trigeminal nerve]]; (2) Middle complex-corresponds to the [[mastoid emissary vein foramen]], which was projected to the facial and [[vestibulocochlear nerve]]s; and (3) Inferior complex-corresponds to the posterior [[condylar canal]], which projects to the [[lower cranial nerve]]s. [[Neuronavigation]] confirmed these [[landmark]]s. Two new triangles were proposed: (1) The Petrous-Acousticofacial triangle, and (2) The Acousticofacial-Trigeminal triangle. Triangles provide a useful anatomical guide to the posterior fossa. Ortiz-Rafael et al. introduced an organized schema, as well as proposed two new triangles, with the intent to minimize manipulation of neurovascular structures
((Ortiz-Rafael J, Chakravarthi SS, Revuelta-Gutiérrez R, Kassam A, Monroy-Sosa A. Microsurgical anatomy of the cranial nerve-centric triangles of the posterior cranial base: cadaveric and radiological anatomical study. Anat Sci Int. 2021 Jun 16. doi: 10.1007/s12565-021-00620-z. Epub ahead of print. PMID: 34132987.)).