Abstract <em>Introduction: </em>Based on Computed Tomography Angiography (CTA) of the brain to determine the distribution of the defined anatomical variations of the Sylvian fissure (SF) in the patient without brain lesions and characteristics of the sphenoidal segment (M1) of the middle cerebral artery (MCA). <em>Patients and methods: </em>A cross-sectional study of 31 patients without intracranial pathologies has conducted from January 2023 – March 2023 in Viet Duc University Hospital. The 5 types-Maslehatys classification was used to evaluate the SF anatomy on CTA as well as M1 of MCA details such as the length, diameter and termination. <em>Results: </em>The patients mean age was 48.68 ± 21.07; male/female ratio was 1.8, symmetric and mirror-imaged coherence of the SF was observed in 17 patients accounting for 54.8%. The highest frequent rate was type 2 accounted for 38.7%, the lowest frequent rate was type 5 in 3.2%, the frequency of type 1, type 3, and type 4 were 19.4%; 22.6%, and 16.1%, respectively. In the MCA study, a bifurcation was observed in 54.8%, a Trifurcation was observed in 9.7% and a false Bifurcation in 35.5%. The mean length of M1 segment of MCA was 17.57 ± 3.16mm, the mean diameter of the M1 segment was 3.12 ± 0.53mm. The distribution of SF types showed significant differences in patients younger than 63 years old. <em>Conclusion: </em>CTA of thecerebral arteries was an effective and useful tool for evaluation of SF and MCA anatomy. <em>Key words: </em>Sylvian fissure, middle cerebral artery, imaged study. References <ol> <li>Tanriover N, Rhoton AL, Kawashima M, Ulm AJ, Yasuda Microsurgical anatomy of the insula and the sylvian fissure. <em>Journal of Neurosurgery. </em>2004;100(5):891-922. doi:10.3171/jns.2004.100.5.0891</li> <li>Collice M, Collice R, Riva A. Who discovered the sylvian FISSURE? <em>Neurosurgery</em>. 2008;63(4):623-628. doi:10.1227/01.NEU.0000327693.86093.3F</li> <li>Gibo H, Carver CC, Rhoton AL, Lenkey C, Mitchell Microsurgical anatomy of the middle cerebral artery. <em>Journal of Neurosurgery</em>. 1981;54(2):151-169. doi:10.3171/jns.1981.54.2.0151</li> <li>Wen HT, Rhoton AL, de Oliveira E, Castro LHM, Figueiredo EG, Teixeira Microsurgical anatomy of the temporal lobe: part 2—sylvian fissure region and its clinical application. <em>Operative </em><em>Neurosurgery</em>. 2009;65(6):ons1-ons36. doi:10.1227/01. NEU.0000336314.20759.85</li> <li>Ngando H, Maslehaty H, Schreiber L, Blaeser K, Scholz M, Petridis Anatomical configuration of the Sylvian fissure and its influence on outcome after pterional approach for microsurgical aneurysm clipping. <em>Surg Neurol </em>Int. 2013;4(1):129. doi:10.4103/2152- 7806.119073</li> <li>Ture U, Yasargil DCH, Al-Mefty O, Yasargil Topographic anatomy of the insular region. <em>Journal of Neurosurgery. </em>1999;90(4):720-733. doi:10.3171/ jns.1999.90.4.0720</li> <li>Hernesniemi J, Ishii K, Niemela M, et Lateral supraorbital approach as an alternative to the classical pterional approach. In: Yonekawa Y, Keller E, Sakurai Y, Tsukahara T, eds. New Trends of Surgery for Stroke and Its Perioperative Management. Vol 94. <em>Acta Neurochirurgica Supplements</em>. Springer-Verlag; 2005:17-21. doi:10.1007/3-211-27911-3_4</li> <li>Dolenc A Combined Transorbital-Transclinoid and Transsylvian Approach to Carotid-Ophthalmic Aneurysms Without Retraction of the Brain. In: Langmoen IA, Lundar T, Aaslid R, Reulen HJ, eds. <em>Neurosurgical Management of Aneurysmal Subarachnoid Haemorrhage</em>. Springer Vienna; 1999:89- 97. doi:10.1007/978-3-7091-6377-1_8</li> <li>Pritz MB, Chandler The transsylvian approach to middle cerebral artery bifurcation/trifurcation aneurysms. <em>Surgical Neurology</em>. 1994;41(3):217-219. doi:10.1016/0090-3019(94)90124-4</li> <li>Maslehaty H, Deuschl C, Kleist B, Goricke S, Sure U, Muller O. Computed Tomography and Magnetic Resonance Image-Based Analysis of the Anatomical Variations of the Sylvian Fissure and Characteristics of the Middle Cerebral Artery. <em>Clinics and Practice. </em>2017;7(1):890. doi:10.4081/cp.2017.890</li> <li>Nguyen TS, Ngo XK, Nguyen QD, Dao Anatomy of the middle cerebral artery and some related arteries on 256-slice computed tomography images. Published online 2019.</li> </ol> <!--more--> <a href="https://vjsel.vn/wp-content/uploads/2024/01/BAI-9.pdf">Download file PDF</a>
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