Small callosal fenestration: anatomical and clinical study.

BACKGROUND

Traditional callosotomy is associated with neurologic deficits due to surgical damage of corpus callosum and nearby brain structures. To reduce this damage, we studied a small callosal fenestration in cadaver heads and clinical patients.

METHODS

Fifteen cadaver heads were used to study the anatomy of corpus callosum and nearby brain structures. Based on anatomical study, small callosal fenestration was first tested in 5 cadaver heads and then applied to 7 consecutive clinical patients.

RESULTS

In cadaver heads, a 1.5 x 1.5-cm (length x width) small callosal fenestration could provide adequate surgical exposure required for most transcallosal operations. In patients, a 1.0 to 1.5 x 1.0 to 1.7-cm small callosal fenestration provided better surgical exposure than those provided by 2.5 to 3.5 cm of traditional callosotomies in our experience. During 6 months of follow-up, no obvious neurologic deficits related to surgical damage were observed in our patients who underwent small callosotomy.

CONCLUSION

Small callosal fenestration is a promising alternative to traditional callosotomy in neurosurgery, which requires further investigation.