Abstract
Vision is a complex sense that is widely represented in the cortex and involves multiple pathways that can be affected by conditions amenable to surgical treatment. From a neurosurgical point of view, the treatment of major lesions affecting the optic nerve, such as tumours, intracranial hypertension, trauma and aneurysms, can be approached depending on the segment to be worked on and the surrounding structures to be manipulated. Therefore, surgical manipulation of the visual pathway requires a detailed knowledge of functional neuroanatomy. The aim of this review is to present the functional and microsurgical anatomy of the second cranial nerve, through illustrations and cadaveric dissections, to support the choice of the best surgical approach and avoid iatrogenic injuries. For this purpose, a literature search was performed using the PubMed database. Additionally, cadaveric dissections were performed on adult cadaver heads fixed with formaldehyde and injected with coloured silicone.
Highlights
Vision is a complex sense that is widely represented in the cortex and involves multiple pathways that can be affected by conditions amenable to surgical treatment
Surgical manipulation of the visual pathway requires a detailed knowledge of functional neuroanatomy
The aim of this review is to present the functional and microsurgical anatomy of the second cranial nerve, through illustrations and cadaveric dissections, to support the choice of the best surgical approach and avoid iatrogenic injuries
Summary
The optic nerve is an extension of the telencephalon in the form of tracts. Зрительный нерв в виде трактов является продолжением конечного мозга. The ophthalmic artery gives rise to short and long ciliary arteries that emit multiple small branches that penetrate the nerve and form the pial plexus, which is in turn anastomosed by branches of the central artery of the retina to irrigate the intraorbital segment of the optic nerve (Fig. 4b and 4c). Intracranial segment This segment is only 10mm long [46]; the nerve rests on the sellar diaphragm, and more dorsally is in relation to the cavernous sinus, covered only by the pia mater in all its trajectory at this level up to the entry of the optic canal [1, 40] The irrigation of this segment is provided by branches of the anterior cerebral artery, internal carotid artery, and anterior communicating artery (Fig. 5a and 5b) [40]. The anterior cerebral artery and the anterior communicating artery run above the optic chiasm [40]
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