{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T10:37:29Z","timestamp":1789209449409,"version":"build-2803163510"},"reference-count":89,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Fissure dissection is routinely used in the supratentorial region to access deeply situated pathology while minimizing division of neural tissue. Use of fissure dissection is also practical in the posterior fossa. In this study, the microsurgical anatomy of the 3 cerebellar-brainstem fissures (cerebellomesencephalic, cerebellopontine, and cerebellomedullary) and the various procedures exposing these fissures in brainstem surgery were examined.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Seven cadaveric heads were examined with a microsurgical technique and 3 with fiber dissection to clarify the anatomy of the cerebellar-brainstem and adjacent cerebellar fissures, in which the major vessels and neural structures are located. Several approaches directed along the cerebellar surfaces and fissures, including the supracerebellar infratentorial, occipital transtentorial, retrosigmoid, and midline suboccipital approaches, were examined. The 3 heads examined using fiber dissection defined the anatomy of the cerebellar peduncles coursing in the depths of these fissures.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Dissections directed along the cerebellar-brainstem and cerebellar fissures provided access to the posterior and posterolateral midbrain and upper pons, lateral pons, floor and lateral wall of the fourth ventricle, and dorsal and lateral medulla.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Opening the cerebellar-brainstem and adjacent cerebellar fissures provided access to the brainstem surface hidden by the cerebellum, while minimizing division of neural tissue. Most of the major cerebellar arteries, veins, and vital neural structures are located in or near these fissures and can be accessed through them.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.2.jns142707","type":"journal-article","created":{"date-parts":[[2015,8,14]],"date-time":"2015-08-14T14:00:06Z","timestamp":1439560806000},"page":"248-263","source":"Crossref","is-referenced-by-count":62,"title":["Anatomy and approaches along the cerebellar-brainstem fissures"],"prefix":"10.3171","volume":"124","author":[{"given":"Ken","family":"Matsushima","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Florida, Gainesville, Florida; and"},{"name":"Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaan","family":"Yagmurlu","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Florida, Gainesville, Florida; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michihiro","family":"Kohno","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert L.","family":"Rhoton","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Florida, Gainesville, Florida; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"Suppl3","key":"b1-jns142707","series-title":"Neurosurgery","first-page":"472","article-title":"The far lateral transponto-medullary sulcus approach to pontine cavernous malformations: technical report and surgical results","volume":"10","author":"Abla","year":"2014"},{"issue":"1 Suppl","key":"b2-jns142707","series-title":"Neurosurg Focus","first-page":"1","article-title":"Resection of pontine cavernous malformation through the pontomedullary sulcus","volume":"36","author":"Abla","year":"2014"},{"key":"b3-jns142707","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1227\/NEU.0b013e3181ff9cde","article-title":"Advances in the treatment and outcome of brainstem cavernous malformation surgery: a single-center case series of 300 surgically treated patients","volume":"68","author":"Abla","year":"2011"},{"key":"b4-jns142707","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.wneu.2012.06.011","article-title":"Brainstem cavernoma surgery: the state of the art","volume":"80","author":"Abla","year":"2013"},{"issue":"3","key":"b5-jns142707","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E8","DOI":"10.3171\/2010.6.FOCUS10128","article-title":"Surgical approaches to brainstem cavernous malformations","volume":"29","author":"Abla","year":"2010"},{"key":"b6-jns142707","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"922","DOI":"10.3171\/jns.2002.97.4.0922","article-title":"Comparison of different infratentorial-supracerebellar approaches to the posterior and middle incisural space: a cadaveric study","volume":"97","author":"Ammirati","year":"2002"},{"issue":"3","key":"b7-jns142707","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E10","DOI":"10.3171\/2010.6.FOCUS10134","article-title":"Operative management of brainstem cavernous malformations","volume":"29","author":"Asaad","year":"2010"},{"key":"b8-jns142707","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1227\/00006123-198205000-00005","article-title":"Retromastoid approach for biopsy of brain stem tumors","volume":"10","author":"Baghai","year":"1982"},{"key":"b9-jns142707","series-title":"Neurosurg Rev","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s101430100179","article-title":"Cerebral cavernomas in the adult. 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