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Techniques of Sylvian Fissure Split

Last Updated: April 17, 2019

Step-by-Step Dissection of the Sylvian Fissure Using the Inside-to-Outside Technique

Dissection of a Difficult Fissure for a Ruptured MCA Aneurysm

Figure 1: Generous dissection of the Sylvian fissure allows atraumatic clip ligation of cerebral aneurysms (inset) using dynamic retraction.

The evolution of microsurgical techniques has facilitated preservation of normal brain tissue while providing surgeons with a reasonable access to deep brain lesions. The application of these techniques to intra-cisternal and subarachnoidal dissection has created safe surgical corridors. Specifically, the dissection of the Sylvian fissure allows exposure of the structures around the anterior circle of Willis, parainsular regions, mesiobasal temporal lobe, and interpeduncular cisterns, with minimal...