Morphometric Study of the Internal Globus Pallidus Using the Robert, Barnard, and Brown Staining Method

• Published in: World neurosurgery Vol. 126; pp. e371 - e378
• Main Authors: dos Santos, Emanuel Cassou, da Luz Veronez, Djanira Aparecida, de Almeida, Daniel Benzecry, Piedade, Guilherme Santos, Oldoni, Carolina, de Meneses, Murilo Sousa, Marques, Mayara Silva
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2019
• Subjects: Cadaver; Deep brain stimulation; Globus Pallidus - anatomy & histology; Humans; Internal globus pallidus; Neuroanatomy; Pallidotomy; Parkinson's disease; Staining and Labeling - methods; Stereotactic atlas; Internal globus pallidus; Gpi; Parkinson's disease; DBS; PD; Deep brain stimulation; Pallidotomy; MRI; Neuroanatomy; Stereotactic atlas
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2019.02.059

The globus pallidus internus (Gpi) is a major target in functional neurosurgery. Anatomical studies are crucial for correct planning and good surgical outcomes in this region. The present study described the anatomical coordinates of the Gpi and its relationship with other brain structures and compared the findings with those from previous anatomical studies. We obtained 35 coronal and 5 horizontal brain specimens from the Department of Anatomy and stained them using the Robert, Barnard, and Brown technique. After excluding defective samples, 60 nuclei were analyzed by assessing their distances to the anatomical references and the trajectories to these nuclei. The barycenter of the Gpi was identified at the level of the mammillary bodies and 1 cm above the intercommissural plane. Thereafter, the distances to other structures were found. The mean ± standard deviation distance was 15.62 ± 2.66 mm to the wall of the third ventricle and 17.02 ± 2.69 mm to its midline, 4.74 ± 1.12 mm to the optic tract, 2.51 ± 0.8 mm and 13.56 ± 2 mm to the internal and external capsule, and 21.3 ± 2.44 mm to the insular cortex. The cortical point of entry should be located 22.03 ± 4.34 mm to 48.74 ± 4.44 mm from the midline. The Gpi has less variability in distance to closer anatomical references, such as the optic tract and internal capsule. Distant locations showed a more inhomogeneous pattern. Anatomical studies such as ours are important for the development of new therapeutic approaches and can be used as a basis for new research involving volumetric and specific group analyses.