THE DENTATE NUCLEUS AND THE FLEECE OF STILLING: NARRATIVE REVIEW ON THE HISTORY OF INTRACEREBELLAR WHITE MATTER ANATOMY

Introduction: The cerebellum harbors a variety of different functions, ranging from motor to cognitive and linguistic skills. This complex functional landscape is founded on an intricate and specific architecture of intracerebellar white matter fibers surrounding the dentate nucleus, which is extremely difficult to visualize with modern imaging techniques. Though, surgeons may greatly benefit from detailed knowledge of this anatomy. Historic studies have proved how anatomic dissections allow an accurate study of intracerebellar white matter bundles, providing essential information about the relations between dentatenucleus, cerebellar cortex and cerebellar peduncles. Throughout the centuries, the concept of dentate capsule, the so called Fleece of Stilling, has been demonstrated by multiple Authors but has been neglected in recent times.Materials and Methods: An extensive historical literature research was conducted through multiple digital libraries, searching for complete digitalized works of selected historical anatomists, with the specific goal of reconstructing the evolution of knowledge relative to intracerebellar white matter architecture from the second half of the XVIIIth century to recent years. Key Authors have been selected and their original works were studied and reviewed.Results: Essays and atlases from Malacarne, Vicq d’Azyr, Reil, Meckel, Arnold, Stilling, Cajal, Dejerine and Jakob were collected. Their anatomic descriptions and illustrations were discussed and detailed, demonstrating their discoveries about intracerebellar white matter anatomy.Conclusion: Information deriving from studies performed by the major anatomists of the past highlights pivotal anatomical information. Integration of this knowledge with modern imaging technologies may have an important surgical impact.