THE MICROSURGICAL ANATOMY OF THE GYRUS RECTUS AREA AND ITS NEUROSURGICAL IMPLICATIONS

Surgical approaches to the frontal basal region as those applied to the anterior communicating artery (AntCommA) aneurysms can lead to post-operative deficits such as memory impairment, executive function disturbances and personality changes(1-4). Some of such disturbances may be caused by an aneurysm rupture itself followed by vasospasm or direct injury to the brain parenquima(3,4). This is especially true when we consider that many AnCommA aneurysm surgery cases are performed with a variable coagulation degree followed by the gyrus rectus aspiration (GR) in order to provide an appropriate exposure to the vessels. The knowledge concerning the pathways around the gyrus rectus is important to avoid destroying some fiber tracts with its inherent post-operative disturbances. We reviewed the microanatomy in this area and the correlation of this zone with the limbic system, the caudate nucleus head and nucleus accumbens septi in order to establish the application of such acquired knowledge to the most common surgical procedures in this area besides formulating some important landmarks. The nervous, arterial and venous relationship of this area was also studied.671909