Abstract
Objective To define the entrance point of the trochlear nerve in the free edge of the tentorium,
giving a topographical description in relation to supratentorial and infratentorial
reference points.
Method The study was performed on seven formaldehyde-fixed specimens (14 sides). The distance
from supratentorial and infratentorial reference points to the entrance point of the
trochlear nerve into the free tentorial edge was measured.
Results The cisternal segment of the trochlear nerve, the tentorial entry point, and the
reference points could be clearly identified in all specimens. The assessed distances
measured from the tentorial entry point of the trochlear nerve to the anterior clinoid
process was 14 to 28 mm, to the posterior clinoid process was 9 to 19 mm, to the posterior
lip of the inner auditory canal was 25 to 29 mm, to the posterior border of the Meckel
cave was 9 to 14 mm, and to the oculomotor triangle was 5 to 16 mm.
Conclusions The cisternal length of the trochlear nerve shows a marked variability and may be
further distorted by tumors, whereas the entry point into the tentorium is a stable
landmark. Therefore, it might be an important reference point for identifying the
nerve before cutting the tentorium.
Keywords
trochlear nerve - cranial nerve IV - tentorial notch - lateral incisural space
