• Ruben Rodríguez-Mena and Uğur Türe.
• Department of Neurosurgery, Yeditepe University School of Medicine, Kozyatagi Kadikoy, Istanbul, Turkey.
• World Neurosurg. 2017 Mar 1; 99: 241-250.

ObjectiveThe dense and complex distribution of neural structures in the brainstem makes it challenging to understand their real configuration. We used the fiber microdissection technique to show the course of the medial and lateral lemnisci within the brainstem. Although these structures seem anatomically alike, they are functionally distinct.MethodsFifteen human brainstems and 8 brain hemispheres (formalin-fixed and previously frozen) were dissected and studied under the operating microscope by applying the fiber microdissection technique.ResultsWe delineated and described the medial and lateral lemnisci, noting their gross elaborate arrangement. These structures are intimately compact and closely related to one another in their common trajectory through the tegmenta of the pons and midbrain. However, we were not able to identify the exact origin and termination of their fibers or the accurate delimitation between the medial lemniscus, spinothalamic tract, and lateral lemniscus along their course in the brainstem.ConclusionsUsing the fiber microdissection technique, we were able to define a general perspective of the topography and architecture of the medial and lateral lemnisci in the brainstem. This perspective should be incorporated into interpretations of magnetic resonance imaging techniques, recognizing both their benefits and limitations. It should also be applied to surgical planning and strategies to achieve a safer and more precise microsurgical procedure.Copyright © 2016 Elsevier Inc. All rights reserved.

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