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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2025; 44(03): e188-e194
DOI: 10.1055/s-0045-1809963
Original Article

Cadaveric Anatomic Study of Pituitary Stalk Mobilization: Implications for Neurosurgery

Estudo anatômico em cadáveres da mobilização do pedúnculo hipofisário: Implicações para neurocirurgia

Autoren

  • Oguz Altunyuva 

    1   Department of Neurosurgery, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey

  • Reyhan Kasab 

    1   Department of Neurosurgery, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey

  • Recep Fedakar 

    2   Department of Forensic Medicine, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey

  • Selcuk Yilmazlar 

    1   Department of Neurosurgery, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey

Funding The authors received no financial support for the research, authorship, and/or publication of this article.
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Abstract

Objetive

Surgical intervention in the subchiasmal region is complex due to the presence of critical neurovascular structures. This study aimed to elucidate the detailed anatomy of this region and identify safe surgical mobilization techniques.

Methods

Eight cadaveric specimens underwent anatomical dissection to examine the subchiasmal region, its neurovascular components, and skull base structures. The supportive structures of the pituitary stalk were meticulously exposed to assess its mobility.

Results

During dissection of the arachnoid membranes surrounding the pituitary stalk, two distinct, thick arachnoid bands were identified enveloping the stalk and superior hypophyseal arteries. These bands were situated within the inner layer of the arachnoid membranes, forming a funnel-like structure that enclosed and protected the pituitary stalk. These bands originated from the inferior aspects of the bilateral optic nerves and extended medially from both internal carotid arteries.

Conclusion

The internal arachnoid bands identified in our study encase and protected the superior hypophyseal arteries. By stabilizing the pituitary stalk and preserving pituitary gland perfusion, these bands may act as a protective mechanism against neuroendocrine complications, such as diabetes insipidus, particularly in mild to moderate head trauma.

Resumo

Objetivo

A intervenção cirúrgica na região subquiasmática é complexa devido à presença de estruturas neurovasculares críticas. Este estudo teve como objetivo elucidar a anatomia detalhada desta região e identificar técnicas seguras para a mobilização cirúrgica.

Métodos

Foram dissecados oito espécimes cadavéricos para examinar detalhadamente a região subquiasmática, seus componentes neurovasculares e as estruturas da base do crânio. As estruturas de suporte do pedúnculo hipofisário foram cuidadosamente expostas para avaliar sua mobilidade.

Resultados

Durante a dissecação das membranas aracnoides que envolvem o pedúnculo hipofisário, foram identificadas duas bandas aracnoideas distintas e espessas, envolvendo o pedúnculo e as artérias hipofisárias superiores. Essas bandas estavam situadas na camada interna das membranas aracnoideas, formando uma estrutura semelhante a um funil, que envolvia e protegia o pedúnculo hipofisário. As bandas tiveram origem nas faces inferiores dos nervos ópticos bilaterais e se estendiam medialmente a partir de ambas as artérias carótidas internas.

Conclusão

As bandas aracnoideas internas identificadas em nosso estudo envolvem e protegem as artérias hipofisárias superiores. Ao estabilizar o pedúnculo hipofisário e preservar a perfusão da glândula pituitária, essas bandas podem atuar como um mecanismo protetor contra complicações neuroendócrinas, como diabetes insipidus, particularmente em traumas cranianos leves a moderados.

Keywords

skull base - subchiasmal region - arachnoid bands - surgical mobilization - pituitary

Palavras-chave

base do crânio - região subquiasmática - bandas aracnoideas - mobilização cirúrgica - hipófise

Authors' Contributions

SY, RF, OA, RK: material preparation, data collection, and data analysis; OA: writing — original draft; SY: critical revision and supervision. All authors contributed to the conception and design of the study and approved the final version of the manuscript.




Publikationsverlauf

Eingereicht: 30. April 2025

Angenommen: 09. Juni 2025

Artikel online veröffentlicht:
07. Juli 2025

© 2025. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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