Liliequist membrane: A systematic review of history, anatomy, clinical importance, and surgical challenges

• Published in: Clinical neurology and neurosurgery 2024-07, Vol.242, p.108322, Article 108322
• Main Authors: Farooq, Minaam, Ashfaq, Dahir, Ranjha, Kaleem Ullah, Ergen, Anil, Atallah, Oday, Badary, Amr, Scalia, Gianluca
• Format: Article
• Language: English
• Subjects: Anatomy; Boundaries; Case reports; Clinical implications; Clinical Relevance; Clinical significance; Cysts; Diaphragm; Dissection; Endoscopy; Hemorrhage; History, 19th Century; History, 20th Century; Humans; Investigations; Liliequist membrane; Neuroanatomy; Neurosurgery; Neurosurgical Procedures - history; Neurosurgical Procedures - methods; Observational studies; Radiological evaluation; Radiology; Systematic review
• ISSN: 0303-8467; 1872-6968; 1872-6968
• DOI: 10.1016/j.clineuro.2024.108322

The Liliequist membrane (LM) represents a crucial yet challenging anatomical structure in neuroanatomy. First observed in 1875 and later elucidated by Bengt Liliequist in 1956, the LM's precise anatomical description and boundaries remain complex. Its significance extends to neurosurgery, impacting various procedures like endoscopic third ventriculocisternostomies, aneurysm and tumor surgeries, treatment of suprasellar arachnoid cysts, and managing perimesencephalic hemorrhages. However, a comprehensive understanding of the LM is hindered by inconsistent anatomical descriptions and limitations in available literature, warranting a systematic review. A systematic review was conducted by searching PubMed, Science Direct, and Google Scholar for articles pertaining to Liliequist's membrane. The search employed Mesh terms like "Liliequist membrane," "Liliequist's diaphragm," and related variations. Inclusion criteria encompassed studies exploring the historical evolution, anatomical structure, radiological characteristics, and clinical implications of the LM in neurosurgery. The search yielded 358 articles, with 276 unique articles screened based on relevance. Following a meticulous screening process, 72 articles underwent full-text assessment, resulting in the inclusion of 5 articles meeting the eligibility criteria. The selected studies varied in methodology, including anatomical dissections, radiological evaluations, and clinical significance in neurosurgical procedures. Insights were derived on LM's anatomical variations, radiological visualization, and its critical role in guiding neurosurgical interventions. Despite advancements in understanding its clinical significance and radiological visualization, challenges persist in precisely delineating its boundaries. Further research, especially on embryological development and histological characterization, is essential. Enhancing comprehension of LM-related pathologies is crucial for accurate preoperative planning and optimizing patient outcomes in neurosurgery. •Membrane of the Liliequist or Liliequist membrane (LM) is named after the Swedish Neuroradiologist Bengt Eric Liliequist.•This review will delve into the historical background, anatomy, radiological aspects, and clinical significance of LM.•Electronic databases such as PubMed, ScienceDirect and Google Scholars were searched comprehensively to extract the available literature on Liliequist membrane.•Despite the recognition of LM as an important landma