Table 1.
The essential anatomical data and clinical relevance of included articles about the membrane of Liliequist
| Study | Perforations | Number of leaves | Lateral insertion | Relation with oculomotor | Superior attachment | Type of study | Clinical relevance |
|---|---|---|---|---|---|---|---|
| Liliequist, 1959 [18] | Absent | 1 | N/A | N/A | Premamillary | Radiological | First description |
| Yaşargil, 1976 [32] | Perforated by Pcom | 1 | Mesiotemporal | Surrounds them | Premamillary | Intraoperative observations | Surrounds oculomotor nerve and is pierced by the posterior communicating artery, relevant during aneurysm surgery |
| Matsuno, 1988 [23] | Mesencephalic membrane | 2 | Attached to oculomotor nerves, not obvious if this is the lateral border | Attached to them | Retromamillary (posterior edge of mamillary bodies) |
Cadaveric study (15); formalin-fixed heads |
Forms a bridge of arachnoid membrane between the two oculomotor nerves. Also, retromamillary attachment relevant in 3rd ventriculocisternostomies. |
| Brasil, 1993 [2] | Pierced by oculomotor | 1 | Mesiotemporal | Surrounds them - arachnoidal cuff | Premamillary | Cadaveric study (7); gelatin infusion in the subarachnoid space | First description of the cuff surrounding the oculomotor nerve forming the oculomotor cistern |
| Zhang, 2000 [33] | Absent | 2 | Tentorium | Thin porous trabecular arachnoid cuff surrounds them | Free superoposterior border | Cadaveric study; sheet plastination (3), dissection (35) | Membrane extends to the tentorium, where it attaches, important in transtentorial approaches |
| Vinas, 2001 [29] | Pcom enters interpeduncular cistern after perforating membrane | 1 | Mesiotemporal | Surrounded by caudal oculomotor membrane which joins mesencephalic membrane to form membrane of Liliequist | Retromamillary | Cadaveric study (20); formalin-fixed heads submersed in Ringer’s lactate | Describes the trajectory of the posterior communicating artery which pierces the membrane before entering the interpeduncular cistern to join the Posterior Cerebral artery. This is relevant for approaches where aneurysms of the posterior communicating artery are dissected or in which posterior circulation aneurysms must be dissected from surrounding arachnoid |
| Lu, 2003 [21] | Pcom near inferior border of diencephalic membrane | 3, diencephalic-mesencephalic leaf extra | Mesiotemporal | When posterior communicating membrane attached to Liliequist’s membrane, arachnoid cuff around nerve | Premamillary | Cadaveric study (8); formalin-fixed heads | Identifies posterior communicating artery near the border of the diencephalic membrane, relevant in 3rd ventriculocisternostomies where this artery along with the posterior cerebral artery may be damaged |
| Froelich, 2008 [11] | Absent | 2 | Pia of the parahippocampal gyrus | Between two layers of mesencephalic leaf or above mesencephalic leaf, always surrounded by arachnoidal cuff until entry into cavernous sinus | Premamillary | Cadaveric study (13); formalin-fixed heads, endoscopic followed by microsurgical dissection | Explains risks of supratentorial dissection to infratentorial artery system. |
| Anik, 2011 [1] | Absent | 2 | Extends to oculomotor, gives rise to arachnoid trabeculations from then on | Variable, oculomotor usually surrounded by 1 leaf and 1 other arachnoid membrane | To the mamillary bodies themselves | Cadaveric study (24); fresh cadavers, endoscopic and microsurgical dissection | |
| Wang, 2011 [30] | Absent | 3, hypothalamic membrane extra | Oculomotor and cerebellar tentorial incisura | Surrounded by membrane | Tuber cinereum or premamillary | Cadaveric study (15); formalin-fixed heads | Extra membrane hypothalamic membrane and adhesion to tuber cinereum which may explain hypothalamic injuries in careless dissection of piercing of the membrane. |
| Zhang, 2012 [33] | Absent | 2 | Tentorial edge and more than half of the specimens further to the uncus | Covers nerve together with another arachnoid membrane with which it unites forming the true temporal membrane which attaches mesiotemporally | Premamillary | Cadaveric study (24) and histologic study (4); Formalin-fixed heads dissected microsurgically. Histological study: sellar and suprasellar region removed en-bloc and cut into 5-μm slices | Demonstrates the extent of variability of the membrane. |
| Kurucz, 2013 [15] | Small perforations in the diencephalic leaf | 2 |
Medial edge of the temporal membrane and connected to the posterior edge of the medial carotid membrane |
Covers it and is connected to the lateral mesencephalic membrane under the nerve | Premamillary (75%) and retromamillary (25%) | Cadaveric study (110); fresh cadavers, endoscopic technique only, mostly through keyhole approaches | The largest study with one of the best techniques that preserves in-situ anatomy and provides a clear 3D view of the interplay between the outer arachnoid, basal arachnoid and inner arachnoid membranes. |
| Ciappetta, 2017 [5] | N/A | 2 | N/A | Surrounden by membrane | Retromamillary | Cadaveric study (10); fresh cadavers, microsurgical dissection | Just like Kurucz 2012, draws attention that the membrane originates in the basal membrane corresponding to the dorsum sellae. Trabeculae originating from the superior surface of the Liliequist membrane attach to the inferolateral surface of the optic chiasm and to the posterior and posterolateral surface of the pituitary stalk overlapping the basal arachnoid membrane. |