Ambient wing cistern: History, anatomy, imaging and approaches: An overview

Background

The ambient cistern is a noncommunicating paramedian dorsal paired cistern according to the Liliequist classification. While the ambient wing cistern is described for the first time in 1875, Key and Retzius and firstly named in 1950 by Dr. Bengt Liliequist (1923–2008). Due to its complex tridimensional anatomy, it has been a subject of confusion in neuroanatomy. Historically, it has been given multiple anatomical definitions. Our paper focuses on the history, development, radiology, and lesions of the AC along with the AWC and explains the latter as an independently constant anatomical structure.

Method

Pubmed and Google Scholar were both consulted for the advanced literature research using the following search string on Pubmed: ((("ambient") AND ("wing")) OR (((retrothalamic) OR (retropulvinar)) (intercommunicant))) AND ("cister∗")) NOT("temprature"). In addition to the following string on Google scholar: Ambient AND wing cisterna OR cistern.

Results

836 results were obtained, after exclusion of unrelated engineering articles and veterinary papers, only 60 papers remained. Ambient wing, retrothalamic, retropulvinar & intercommunicant cisterns were mentioned within the related 60 articles but none of them explained it as a whole research entity independently.

Conclusion

The ambient cistern has supratentorial and infratentorial parts and is continuous with basal cisterns posteriorly giving rise to the ambient wing cistern. They are believed to be separate constantly existing anatomical structures despite their intimate communication and axial perpendicularity. The wing of AC has significance importance in the diagnosis and treatment of the masses lying adjacent to the tentorial hiatus. It can be exposed either by sub temporal or occipital interhemispheric approach as it locates inferoposteriorly to the AC.