open access

Vol 82, No 4 (2023)
Original article
Submitted: 2022-10-18
Accepted: 2022-11-14
Published online: 2022-11-30
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Magnetic resonance based morphometric analysis of the tentorial notch

F. J. Arrambide-Garza1, O. De-La-Garza-Castro1, L. A. Alvarez-Lozada1, E. Carranza-Rodriguez2, A. Quiroga-Garza1, A. Gomez-Sánchez1, R. Pinales-Razo2, R. E. Elizondo-Omaña1, S. Guzman-Lopez1
·
Pubmed: 36472393
·
Folia Morphol 2023;82(4):784-790.
Affiliations
  1. Human Anatomy Department, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
  2. Radiology and Imaging Department, University Hospital “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico

open access

Vol 82, No 4 (2023)
ORIGINAL ARTICLES
Submitted: 2022-10-18
Accepted: 2022-11-14
Published online: 2022-11-30

Abstract

Background: The study of the tentorial notch can improve the understanding
of brain injury mechanisms. Tentorial morphology has been analysed primarily in
cadaveric studies. However, the postmortem effect can cause variability in the
measurements. The objective was to evaluate the morphometry of the tentorial
notch and the third cranial nerve on living subjects using magnetic resonance
imaging (MRI).
Materials and methods: A retrospective cross-sectional study was performed.
Using consecutive cases, 60 MRI scans were analysed for tentorial notch morphology.
Maximum notch width (MNW), notch length (NL), interpedunculoclival (IC)
distance, apicotectal (AT) distance, third cranial nerve (CN-III) distance, and inter-
CN-III angle, were obtained. For the classification of the tentorial notch quartile
distribution technique for MNW, NL, AT distance, and IC distance were used.
Results: According to the quartile of the MNW, patients were stratified into narrow,
midrange, and wide groups. Using the NL quartile groups, they were also
classified as short, midrange, and long. With these, the tentorial notch could be
classified into eight types. Statistical differences between genders in the MNW
and inter-CN-III angle were found, as well as a strong positive correlation between
NL and AT distance, and between right and left CN-III distances.
Conclusions: There were differences between the cadaveric samples and living
subjects in the CN-III distances. This difference could be explained by the dehydration
of brain volume in the postmortem process which may cause nerve
elongation. Morphometry of the tentorial notch and its neurovascular relations
allows a better understanding of the mechanisms of brain herniation.

Abstract

Background: The study of the tentorial notch can improve the understanding
of brain injury mechanisms. Tentorial morphology has been analysed primarily in
cadaveric studies. However, the postmortem effect can cause variability in the
measurements. The objective was to evaluate the morphometry of the tentorial
notch and the third cranial nerve on living subjects using magnetic resonance
imaging (MRI).
Materials and methods: A retrospective cross-sectional study was performed.
Using consecutive cases, 60 MRI scans were analysed for tentorial notch morphology.
Maximum notch width (MNW), notch length (NL), interpedunculoclival (IC)
distance, apicotectal (AT) distance, third cranial nerve (CN-III) distance, and inter-
CN-III angle, were obtained. For the classification of the tentorial notch quartile
distribution technique for MNW, NL, AT distance, and IC distance were used.
Results: According to the quartile of the MNW, patients were stratified into narrow,
midrange, and wide groups. Using the NL quartile groups, they were also
classified as short, midrange, and long. With these, the tentorial notch could be
classified into eight types. Statistical differences between genders in the MNW
and inter-CN-III angle were found, as well as a strong positive correlation between
NL and AT distance, and between right and left CN-III distances.
Conclusions: There were differences between the cadaveric samples and living
subjects in the CN-III distances. This difference could be explained by the dehydration
of brain volume in the postmortem process which may cause nerve
elongation. Morphometry of the tentorial notch and its neurovascular relations
allows a better understanding of the mechanisms of brain herniation.

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Keywords

tentorial notch, third cranial nerve, brainstem, brain herniation

About this article
Title

Magnetic resonance based morphometric analysis of the tentorial notch

Journal

Folia Morphologica

Issue

Vol 82, No 4 (2023)

Article type

Original article

Pages

784-790

Published online

2022-11-30

Page views

733

Article views/downloads

500

DOI

10.5603/FM.a2022.0103

Pubmed

36472393

Bibliographic record

Folia Morphol 2023;82(4):784-790.

Keywords

tentorial notch
third cranial nerve
brainstem
brain herniation

Authors

F. J. Arrambide-Garza
O. De-La-Garza-Castro
L. A. Alvarez-Lozada
E. Carranza-Rodriguez
A. Quiroga-Garza
A. Gomez-Sánchez
R. Pinales-Razo
R. E. Elizondo-Omaña
S. Guzman-Lopez

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