Huseyin Mert Cerci

Objective: Supratentorial cisterns are specialized compartments of the subarachnoid space that contain critical neurovascular structures and provide natural corridors to deep intracranial regions. These cisternal spaces play an essential role in the surgical management of various intracranial pathologies, including aneurysms and skull base tumors. Therefore, a precise understanding of their microsurgical anatomy is fundamental for safe neurosurgical practice. Methods: This study evaluated the microsurgical anatomy and surgical relevance of supratentorial cisterns through the analysis of neurosurgical procedures involving pathologies located within these regions. Intraoperative findings were documented with high-definition imaging, focusing on arachnoid dissection, cerebrospinal fluid (CSF) release, and identification of neurovascular structures. Postoperative imaging was also reviewed to correlate operative exposure with anatomical landmarks. Results: Several supratentorial cisterns were identified and analyzed, including the sylvian, carotid, chiasmatic, lamina terminalis, pericallosal, olfactory, and oculomotor cisterns. Each cistern demonstrated specific anatomical boundaries and characteristic neurovascular contents. The sylvian cistern provided a principal corridor to the middle cerebral artery complex, whereas the carotid and chiasmatic cisterns were closely associated with the internal carotid artery and optic apparatus. The lamina terminalis and pericallosal cisterns served as key pathways for accessing the anterior cerebral artery and interhemispheric structures. Conclusion: Supratentorial cisterns represent fundamental anatomical corridors in cranial surgery. Detailed knowledge of their microsurgical anatomy facilitates safe surgical dissection, enhances neurovascular orientation, and allows effective CSF drainage, thereby reducing the need for brain retraction and improving operative safety. Cite this article as: Aydın L, Kartum TA, Çerçi HM, Tanrıverdi T. Microsurgical and radiological consideration of the supratentorial brain cisterns. Cerrahpaşa Med J 2026, 50, 0048, doi: 10.5152/cjm.2026.26048.

BACKGROUND AND OBJECTIVES: Intrathecal baclofen (ITB) for severe spasticity can encounter complications such as wound dehiscence and ulcers because of elevated intracompartmental pressure within the abdominal subcutaneous and subfascial pocket housing the pump. We propose an innovative technique to manage ITB wound ulcers. METHODS: Resecting the umbilicus create a more spacious and less tension-prone pocket for the ITB pump. RESULTS: Between 2015 and 2023, we implanted ITB pumps in 65 patients. Among them, 5 patients presented with skin ulcer or dehiscence underwent surgery using the novel technique. Postoperative follow-up revealed successful wound healing, with no further wound-related complications. CONCLUSION: The proposed technique provides effective and practical solution to wound and skin complications related to ITB pump. Moreover, it may serve as a viable preemptive strategy during the initial implantation of the ITB pump in selected patients.