颞叶内侧区显微解剖及手术入路研究
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摘要
目的1．研究颞叶内侧区解剖及其与周围结构的毗邻关系；2．研究到达颞叶内侧区的手术入路；3．研究颞叶内侧和邻近环池的血液供应。
方法1、1 5个灌注有彩色硅胶的尸头标本和30侧大脑半球标本进行显微镜下解剖，观察颞叶内侧结构的组成及相互关系，颞叶内侧结构和颈内动脉、大脑中动脉、后交通动脉、脉络膜前动脉、大脑后动脉、基底静脉的解剖关系。2、根据通过下脉络点和四叠体水平的两条横线将颞叶内侧区分为前、中、后三部分，根据经过颞叶表面的不同将手术入路分为上、底、外、内四组，颞上组包括经侧裂—岛叶入路；内侧组包括前部经侧裂—脑池入路、后部经枕半球间入路、小脑上经小脑幕入路；颞底组指颞下入路；外侧组包括经颞外侧皮层入路和经颞沟入路，在15具尸头上模拟这些手术入路，研究各个手术入路的优缺点、观察颞叶桥静脉的走行、汇入点位置和形态特点以及其对手术入路的影响。
结果
1、海马旁回通过侧副沟、鼻状沟和外侧的梭状回分界，30侧半球均存在侧副沟，从前向后连续走行，其前端6侧(5具尸头)与鼻状沟相连续，24侧(80％)二者不连续。大脑后动脉的颞下分支从海马旁回底面向外侧走行进入侧副沟，绕出后分布在颞叶底面，根据颞下分支可以确定侧副沟的位置。
2、海马和伞位于颞角底部内侧，海马长48．8mm±2．6mm，分为头、体、尾三部分，海马头横径19．24±2．3mm，前后径17．56±3．6mm，体长24．42±4．6mm，尾部横径7．88±2．4mm，前后径6．82±1．2mm。海马头表面有趾状突，表面无脉络丛，组成颞角前部的内侧壁。脉络丛覆盖于海马体尾部。
3、杏仁核后部向颞角上方膨出，90％和海马头前部相接，组成颞角的前上壁，完全在钩的范围内，杏仁核上方和苍白球无明显分界。
4、脑沟至颞角的距离，经侧副沟至颞角的距离最短，在钩尖水平为2．81±0．14mm，下脉络点水平为3．19±0．65mm；其次为下环岛沟，在钩尖和下脉络点水平至颞角的距离分别为6．08±1．32mm，6．58±2．12mm。脑回至颞角的距离，海马旁回距离最短，在钩尖水平为6．80±2．16mm，下脉络点水平为12．32±2．92mm。
5、下脉络点位于海马头后部，对应钩后段的后界及最高点。下脉络点至颞极的距离为45．96±6．56mm，至海马头的距离为17．56±3．49mm，与钩尖的距离为10．88±2．34mm。
6、脉络膜前动脉池段前半部73％在钩前内侧面上1／3，9％在钩前内侧面中1／3，钩前内侧面下1／3占18％；脉络膜前动脉池段后半部和钩后段位置关系：91％在钩后内侧面上1／3，钩后内侧面下1／3占9％。大脑后动脉P2a段和钩后段相邻，P2a58％位于钩切迹水平，33％在钩切迹之上，9％在钩切迹之下。
7、共发现125支海马动脉，平均每侧4．2支(2—7支)，74．4％发自大脑后动脉主干及其分支；在大脑后动脉及其分支中，颞下前动脉最常发出海马动脉，25侧(83．3％)颞下前动脉发出26支(20．8％)海马动脉；6支钩—海马动脉发自颞下前动脉，供应海马体尾，齿状回。25侧(83．3％)半球共有32支(25．6％)海马动脉发自脉络膜前动脉，主要供应海马头，二者的海马动脉分支在钩后段下面形成吻合。
8、经侧裂—岛叶入路、经侧裂—脑池入路、经颞叶皮层或脑沟入路、颞下入路可暴露颞叶内侧区前部。颞下入路、经颞外侧入路可暴露颞叶内侧中部结构，中部病变需要根据病变的性质选择手术入路。后部入路包括经枕半球间入路和小脑上经小脑幕入路，可暴露颞叶内侧后部结构。
9、共发现32条Labb(?)静脉。每侧半球有2条Labb(?)静脉者2侧，有1条Labb(?)静脉者28侧。Labb(?)静脉在颞叶外侧面走行的位置在颞中静脉引流区和颞后静脉引流区，分别占40．6％和53．1％，颞前静脉分布区占6．3％。汇入点在横窦区20条，占62．5％，天幕前区和天幕后区各6条，占37．5％。距离窦硬膜点的距离左侧19．84±4．68mm(5．28～30．1 6mm)，右侧20．62±5．42mm(7．1 6～29．72mm)。颞下段的长度为15．86±1．34mm(15．20～16．72mm)，直径为2．68±0．86mm(1．46～4．32mm)。桥静脉汇入静脉窦的位置55％位于横窦区，天幕后区为30％，岩上窦区占9．4％，天幕前区占5．6％。汇入硬膜窦的形式集束型45％，成簇型30％，单支型25％。
10、钩回切除可以增加P2a的暴露范围。
结论1、颞叶内侧和大脑后动脉、脉络膜前动脉池段、脑干、视束、基底静脉等重要结构毗邻，掌握颞叶内侧区解剖及其与毗邻结构的相互关系对于安全进行此部位的手术至关重要。下脉络点、脉络裂、杏仁核与海马头前部相接触的特点是经颞角手术治疗颞叶内侧区病变的重要解剖标志。2、对颞叶内侧区进行分区，不但有助于理解颞叶内侧区的解剖关系，而且对于选择合适的手术入路处理此区病变大有帮助。3、颞叶内侧区的每一个手术入路均有其优缺点，联合入路会弥补单个手术入路的不足。4、钩回部分切除可以作为增加暴露颞叶内侧区前部病变的手段之一。
Objective 1.To explore the anatomy of mesial temporal lobe and the relationshipsbetween the mesial temporal lobe and its surrounding structures.2.To study theapproaches to the medial temporal region.3.To investigate the blood supplying of theadjacent structures of the ambient cistem,particulaly the medial temporal region.
Methods 1.Fifteen formalin—fixed adult cadaveric heads specimens after perfusionof the arteries and veins with colored silicone and thirty cerebral hemispheres werestudied under microscope,and photographs were taken from different angle.Theanatomic structures of the medial temporal region and the relationships among theadjacent structures,internal carotid artery,anterior choroidal artery,posteriorcommunicating artery,Rothensal vein,were studied.2 Transverse lines at the level ofthe inferior choroidal point and quadrigeminal plate were used to divide the medialtemporal region into anterior,middle,and posterior portions.Surgical approaches tothe medial temporal region were classified into four groups:superior,thetranssylvian-transinsular approach,lateral,the temporal transcortical or transsulciapproach,basal,the subtemporal approach,and medial,based on the surface of thelobe through which the approach was directed.The approaches through the medialgroup were subdivided further into an anterior approach,the transsylviantranscisternal approach,and two posterior approaches,the occipital interhemisphericand supracerebellar transtentorial approaches.All the approaches were maderespectively on fifteen cadaveric head specimens,the advantages and disagvantages ofthe approach were evaluated.The impact of temporal bridging veins,including itslocation,course and configuration,on the approaches were explored at the same time.
Results 1.The parahippocampal gyrus separated from fusiform gyrus laterally bycollateral sulcus.The collateral sulcus was present in all 30 hemispheres.Thecollateral sulcus and the rhinal sulcus was constant in 24 sides,the remains were notconstant.The location of the collateral sulcus and consequently the location of thelateral part of the floor of the temporal hom can be determined by following theinferior temporal branches of the posterior cerebral artery as they descend into thedepth of the collateral sulcus before continuing on the surface of the basal temporal gyrus.
2.The hippocampus and the fimbria occupies the medial part of the floor of thetemporal horn The hippocampus is 48.8mm±2.6mm long,including threeparts:head,body and tail.The transverse diameter and the anteroposterior diameter ofthe head of the hippocampus are 19.24±2.3mm,17.56±3.6mm,respectively.the bodyof the hippocampus is 24.42±4.6mm long;The transverse diameter and theanteroposterior diameter of the tail of the hippocampusare7.88±2.4mm,6.82±1.2mm,respectively.The head of the hippocampus characterizedby three or four hippocampal digitations is the only part of the hippocampus that isfree of choroid plexus.
3.The amygdala can be considered as being entirely located within the boundaries ofthe uncus:superiorly,the temporal amygdala blends into the globus pallidus withoutany clear demarcation;inferiorly,the posterior portion of the amygdala bulgesinferiorly from the most anterior portion of the roof of the temporal horn toward thesuperior part of the hippocampal head,and frequently they become fused(90%).Theamygdala is the anterior wall of the temporal horn and also constitutes the mostanterior part of the roof of the temporal horn.
4.The distance from the collateral sulcus to the temporal horn,which is the shortestdiatance among the distances between sulci and temporal horn,is 2.81±0.14mm at thelevel of the apex of the uncus and 3.19±0.65mm at the inferior choroidal point.Thedistance from the inferior limiting sulcus to the roof of temporal horn is6.08±1.32mm at the level of the apex of the uncus and 6.58±2.12mm at the inferiorchoroidal point.The average distance from the parahippocampal gyms to thetemporal horn is 6.80 mm at the level of the apex of uncusnand is 12.32 mm at thelevel of the inferior choroidal point.
5 The choroidal fissure is located between the thalamus and fimbria;it begins at theinferior choroidal point behind the head of the hippocampus and constitutes themedial wall of the posterior two-thirds of the temporal horn.the highest point of theuncus is located at the end of its posteromedial surface,namely at the level of theinferior choroidal point,which is the important anatomic landmark in the temoral hornsurgery.The distances from the inferioe choroidal point to temporal polar,head of hippocampus and the apex of the uncus were 45.96mm,17.56mm,10.88mm,respectively.
6.The proximal half of the cisternal segment of the anterior choroidal artery is relatedto the upper third of the anteromedial surface of the uncus in 73% of the cases,themiddle third of the anteromedial surface of the uncus in 9%,the inferior third of theanteromedial surface of the uncus in 18%;the distal half of the cisternal segment ofthe anterior choroidal artery is related to the upper third of the posteromedial surfaceof the uncus in 91% of the cases,the inferior third in 9%.The P2a segment of theposterior cerebral artery passes at the level of the uncal notch in 58% of thecases,above the level of the uncal notch in 33%,below the level of the uncal notch in9%.
7.There are a total of 125 hippocampal arteries,for an average of 4.2 arteries perhemisphere(range two to seven arteries),originating from the posterior cerebralartery(PCA) and its branches in 74.4%,from AChA in 25.6%.A total of 26 (20.8 %)hippocampul arteries arise from anterior inferior temporal artery(AITA) in 25hemispheres;there are six unco-hippocampul arteries originating from AITA.Thebody and the tail of the hippocampus was supplied by vessels derived mainly fromPCA and its subtemporal branches,the hippocampul artery supplying the head of thehippocampus derived from the anterior choroidal artery (AchA).The inferior surfaceof the posterior segment of uncus was found to be the important anastomotic sitebetween the hippocampal branches of the AchA and the hippocampal branches of thePCA.
8.The anterior portion of the medial temporal region can be reached through thetranssylvian-transinsular approach,the temporal transcortical or transsulci approach,the subtemporal approach,and transsylvian transcisternal approach.The middle partof the medial temporal region can be reached through the transsylvian-transcisternal,subtemporal and the lateral temporal approaches,where the approach must betailored according to the nature of the lesion and its extension to other medialtemporal areas.The posterior group of approaches directed through the medial surfaceare useful for lesions located in the posterior portion.
9.There were 32 Labb(?) veins on 30 sides,1 Labb(?) per specimen was found on 28 sides,and 2 Labb(?)veins per side on 2.The diameter of Labb(?)was 2.68mm (range1.46to 4.32mm) and the length of the subtemporal segment of Labb(?) was 15.86mm(range15.20 to 16.72mm).The majority of the veins of Lab(?) were present at the regions ofthe posterior (53.1%) and middle temporal veins (40.6%),and only 6.3% wereobserved at the region of the anterior temporal veins.The locations of termination ofthe Labb(?) on the transverse sinus in 62.5% of the cases,the posterior tentorial regionin 18.75%,the anterior tentorial region 18.75%,respectively.The distance from leftsino-dura point to the location of termination of Labb(?) was 19.84mm (range 5.28 to30.16mm),the right was 20.62mm (range 7.16 to 29.72mm).There were threeconfigurations,the separated type (25%),the bundle type (45%) and the multipletype (30%),defined as the temporal bridging veins,and the second type was themajor configurations.The locations of terminations of the bridging veins were dividedinto 4 groups:the transverse sinus group (55%),the posterior tentorial group (30%),the superior petrosal sinus group(9.4%),and the anterior tentorial group (5.6%).
10.Resection of uncus can increase the scope of P2a exposed.
Conclusion 1.The structures of the mesial temporal lobe are adjacent to MCA,AChA,brain stem,optic tract and BV,so understanding of the mesial temporal lobeanatomy and the relationships between the mesial temporal lobe and its surroundingstructures is conducive to the microsurgical operations of the mesial temporal lobelesions.Inferior choroidal point,choroidal fissure,the characteristic of the posteriorportion of the amygdala fused with the hippocampul head,are the important surgicallandmarks.2.Dividing the medial temporal region into smaller areas allows for amore precise analysis,not only of the expected anatomic relationships,but also of thepossible choices for the safe resection of the lesion.3.Each approach to medialtemporal lesions has technical or functional drawbacks and combination ofapproaches that should be considered when selecting a surgical treatment for a givenpatient.4.Partial resection of uncus may be used as a method to expose the anteriorportion of medial temporal region.
方法1、1 5个灌注有彩色硅胶的尸头标本和30侧大脑半球标本进行显微镜下解剖，观察颞叶内侧结构的组成及相互关系，颞叶内侧结构和颈内动脉、大脑中动脉、后交通动脉、脉络膜前动脉、大脑后动脉、基底静脉的解剖关系。2、根据通过下脉络点和四叠体水平的两条横线将颞叶内侧区分为前、中、后三部分，根据经过颞叶表面的不同将手术入路分为上、底、外、内四组，颞上组包括经侧裂—岛叶入路；内侧组包括前部经侧裂—脑池入路、后部经枕半球间入路、小脑上经小脑幕入路；颞底组指颞下入路；外侧组包括经颞外侧皮层入路和经颞沟入路，在15具尸头上模拟这些手术入路，研究各个手术入路的优缺点、观察颞叶桥静脉的走行、汇入点位置和形态特点以及其对手术入路的影响。
结果
1、海马旁回通过侧副沟、鼻状沟和外侧的梭状回分界，30侧半球均存在侧副沟，从前向后连续走行，其前端6侧(5具尸头)与鼻状沟相连续，24侧(80％)二者不连续。大脑后动脉的颞下分支从海马旁回底面向外侧走行进入侧副沟，绕出后分布在颞叶底面，根据颞下分支可以确定侧副沟的位置。
2、海马和伞位于颞角底部内侧，海马长48．8mm±2．6mm，分为头、体、尾三部分，海马头横径19．24±2．3mm，前后径17．56±3．6mm，体长24．42±4．6mm，尾部横径7．88±2．4mm，前后径6．82±1．2mm。海马头表面有趾状突，表面无脉络丛，组成颞角前部的内侧壁。脉络丛覆盖于海马体尾部。
3、杏仁核后部向颞角上方膨出，90％和海马头前部相接，组成颞角的前上壁，完全在钩的范围内，杏仁核上方和苍白球无明显分界。
4、脑沟至颞角的距离，经侧副沟至颞角的距离最短，在钩尖水平为2．81±0．14mm，下脉络点水平为3．19±0．65mm；其次为下环岛沟，在钩尖和下脉络点水平至颞角的距离分别为6．08±1．32mm，6．58±2．12mm。脑回至颞角的距离，海马旁回距离最短，在钩尖水平为6．80±2．16mm，下脉络点水平为12．32±2．92mm。
5、下脉络点位于海马头后部，对应钩后段的后界及最高点。下脉络点至颞极的距离为45．96±6．56mm，至海马头的距离为17．56±3．49mm，与钩尖的距离为10．88±2．34mm。
6、脉络膜前动脉池段前半部73％在钩前内侧面上1／3，9％在钩前内侧面中1／3，钩前内侧面下1／3占18％；脉络膜前动脉池段后半部和钩后段位置关系：91％在钩后内侧面上1／3，钩后内侧面下1／3占9％。大脑后动脉P2a段和钩后段相邻，P2a58％位于钩切迹水平，33％在钩切迹之上，9％在钩切迹之下。
7、共发现125支海马动脉，平均每侧4．2支(2—7支)，74．4％发自大脑后动脉主干及其分支；在大脑后动脉及其分支中，颞下前动脉最常发出海马动脉，25侧(83．3％)颞下前动脉发出26支(20．8％)海马动脉；6支钩—海马动脉发自颞下前动脉，供应海马体尾，齿状回。25侧(83．3％)半球共有32支(25．6％)海马动脉发自脉络膜前动脉，主要供应海马头，二者的海马动脉分支在钩后段下面形成吻合。
8、经侧裂—岛叶入路、经侧裂—脑池入路、经颞叶皮层或脑沟入路、颞下入路可暴露颞叶内侧区前部。颞下入路、经颞外侧入路可暴露颞叶内侧中部结构，中部病变需要根据病变的性质选择手术入路。后部入路包括经枕半球间入路和小脑上经小脑幕入路，可暴露颞叶内侧后部结构。
9、共发现32条Labb(?)静脉。每侧半球有2条Labb(?)静脉者2侧，有1条Labb(?)静脉者28侧。Labb(?)静脉在颞叶外侧面走行的位置在颞中静脉引流区和颞后静脉引流区，分别占40．6％和53．1％，颞前静脉分布区占6．3％。汇入点在横窦区20条，占62．5％，天幕前区和天幕后区各6条，占37．5％。距离窦硬膜点的距离左侧19．84±4．68mm(5．28～30．1 6mm)，右侧20．62±5．42mm(7．1 6～29．72mm)。颞下段的长度为15．86±1．34mm(15．20～16．72mm)，直径为2．68±0．86mm(1．46～4．32mm)。桥静脉汇入静脉窦的位置55％位于横窦区，天幕后区为30％，岩上窦区占9．4％，天幕前区占5．6％。汇入硬膜窦的形式集束型45％，成簇型30％，单支型25％。
10、钩回切除可以增加P2a的暴露范围。
结论1、颞叶内侧和大脑后动脉、脉络膜前动脉池段、脑干、视束、基底静脉等重要结构毗邻，掌握颞叶内侧区解剖及其与毗邻结构的相互关系对于安全进行此部位的手术至关重要。下脉络点、脉络裂、杏仁核与海马头前部相接触的特点是经颞角手术治疗颞叶内侧区病变的重要解剖标志。2、对颞叶内侧区进行分区，不但有助于理解颞叶内侧区的解剖关系，而且对于选择合适的手术入路处理此区病变大有帮助。3、颞叶内侧区的每一个手术入路均有其优缺点，联合入路会弥补单个手术入路的不足。4、钩回部分切除可以作为增加暴露颞叶内侧区前部病变的手段之一。
Objective 1.To explore the anatomy of mesial temporal lobe and the relationshipsbetween the mesial temporal lobe and its surrounding structures.2.To study theapproaches to the medial temporal region.3.To investigate the blood supplying of theadjacent structures of the ambient cistem,particulaly the medial temporal region.
Methods 1.Fifteen formalin—fixed adult cadaveric heads specimens after perfusionof the arteries and veins with colored silicone and thirty cerebral hemispheres werestudied under microscope,and photographs were taken from different angle.Theanatomic structures of the medial temporal region and the relationships among theadjacent structures,internal carotid artery,anterior choroidal artery,posteriorcommunicating artery,Rothensal vein,were studied.2 Transverse lines at the level ofthe inferior choroidal point and quadrigeminal plate were used to divide the medialtemporal region into anterior,middle,and posterior portions.Surgical approaches tothe medial temporal region were classified into four groups:superior,thetranssylvian-transinsular approach,lateral,the temporal transcortical or transsulciapproach,basal,the subtemporal approach,and medial,based on the surface of thelobe through which the approach was directed.The approaches through the medialgroup were subdivided further into an anterior approach,the transsylviantranscisternal approach,and two posterior approaches,the occipital interhemisphericand supracerebellar transtentorial approaches.All the approaches were maderespectively on fifteen cadaveric head specimens,the advantages and disagvantages ofthe approach were evaluated.The impact of temporal bridging veins,including itslocation,course and configuration,on the approaches were explored at the same time.
Results 1.The parahippocampal gyrus separated from fusiform gyrus laterally bycollateral sulcus.The collateral sulcus was present in all 30 hemispheres.Thecollateral sulcus and the rhinal sulcus was constant in 24 sides,the remains were notconstant.The location of the collateral sulcus and consequently the location of thelateral part of the floor of the temporal hom can be determined by following theinferior temporal branches of the posterior cerebral artery as they descend into thedepth of the collateral sulcus before continuing on the surface of the basal temporal gyrus.
2.The hippocampus and the fimbria occupies the medial part of the floor of thetemporal horn The hippocampus is 48.8mm±2.6mm long,including threeparts:head,body and tail.The transverse diameter and the anteroposterior diameter ofthe head of the hippocampus are 19.24±2.3mm,17.56±3.6mm,respectively.the bodyof the hippocampus is 24.42±4.6mm long;The transverse diameter and theanteroposterior diameter of the tail of the hippocampusare7.88±2.4mm,6.82±1.2mm,respectively.The head of the hippocampus characterizedby three or four hippocampal digitations is the only part of the hippocampus that isfree of choroid plexus.
3.The amygdala can be considered as being entirely located within the boundaries ofthe uncus:superiorly,the temporal amygdala blends into the globus pallidus withoutany clear demarcation;inferiorly,the posterior portion of the amygdala bulgesinferiorly from the most anterior portion of the roof of the temporal horn toward thesuperior part of the hippocampal head,and frequently they become fused(90%).Theamygdala is the anterior wall of the temporal horn and also constitutes the mostanterior part of the roof of the temporal horn.
4.The distance from the collateral sulcus to the temporal horn,which is the shortestdiatance among the distances between sulci and temporal horn,is 2.81±0.14mm at thelevel of the apex of the uncus and 3.19±0.65mm at the inferior choroidal point.Thedistance from the inferior limiting sulcus to the roof of temporal horn is6.08±1.32mm at the level of the apex of the uncus and 6.58±2.12mm at the inferiorchoroidal point.The average distance from the parahippocampal gyms to thetemporal horn is 6.80 mm at the level of the apex of uncusnand is 12.32 mm at thelevel of the inferior choroidal point.
5 The choroidal fissure is located between the thalamus and fimbria;it begins at theinferior choroidal point behind the head of the hippocampus and constitutes themedial wall of the posterior two-thirds of the temporal horn.the highest point of theuncus is located at the end of its posteromedial surface,namely at the level of theinferior choroidal point,which is the important anatomic landmark in the temoral hornsurgery.The distances from the inferioe choroidal point to temporal polar,head of hippocampus and the apex of the uncus were 45.96mm,17.56mm,10.88mm,respectively.
6.The proximal half of the cisternal segment of the anterior choroidal artery is relatedto the upper third of the anteromedial surface of the uncus in 73% of the cases,themiddle third of the anteromedial surface of the uncus in 9%,the inferior third of theanteromedial surface of the uncus in 18%;the distal half of the cisternal segment ofthe anterior choroidal artery is related to the upper third of the posteromedial surfaceof the uncus in 91% of the cases,the inferior third in 9%.The P2a segment of theposterior cerebral artery passes at the level of the uncal notch in 58% of thecases,above the level of the uncal notch in 33%,below the level of the uncal notch in9%.
7.There are a total of 125 hippocampal arteries,for an average of 4.2 arteries perhemisphere(range two to seven arteries),originating from the posterior cerebralartery(PCA) and its branches in 74.4%,from AChA in 25.6%.A total of 26 (20.8 %)hippocampul arteries arise from anterior inferior temporal artery(AITA) in 25hemispheres;there are six unco-hippocampul arteries originating from AITA.Thebody and the tail of the hippocampus was supplied by vessels derived mainly fromPCA and its subtemporal branches,the hippocampul artery supplying the head of thehippocampus derived from the anterior choroidal artery (AchA).The inferior surfaceof the posterior segment of uncus was found to be the important anastomotic sitebetween the hippocampal branches of the AchA and the hippocampal branches of thePCA.
8.The anterior portion of the medial temporal region can be reached through thetranssylvian-transinsular approach,the temporal transcortical or transsulci approach,the subtemporal approach,and transsylvian transcisternal approach.The middle partof the medial temporal region can be reached through the transsylvian-transcisternal,subtemporal and the lateral temporal approaches,where the approach must betailored according to the nature of the lesion and its extension to other medialtemporal areas.The posterior group of approaches directed through the medial surfaceare useful for lesions located in the posterior portion.
9.There were 32 Labb(?) veins on 30 sides,1 Labb(?) per specimen was found on 28 sides,and 2 Labb(?)veins per side on 2.The diameter of Labb(?)was 2.68mm (range1.46to 4.32mm) and the length of the subtemporal segment of Labb(?) was 15.86mm(range15.20 to 16.72mm).The majority of the veins of Lab(?) were present at the regions ofthe posterior (53.1%) and middle temporal veins (40.6%),and only 6.3% wereobserved at the region of the anterior temporal veins.The locations of termination ofthe Labb(?) on the transverse sinus in 62.5% of the cases,the posterior tentorial regionin 18.75%,the anterior tentorial region 18.75%,respectively.The distance from leftsino-dura point to the location of termination of Labb(?) was 19.84mm (range 5.28 to30.16mm),the right was 20.62mm (range 7.16 to 29.72mm).There were threeconfigurations,the separated type (25%),the bundle type (45%) and the multipletype (30%),defined as the temporal bridging veins,and the second type was themajor configurations.The locations of terminations of the bridging veins were dividedinto 4 groups:the transverse sinus group (55%),the posterior tentorial group (30%),the superior petrosal sinus group(9.4%),and the anterior tentorial group (5.6%).
10.Resection of uncus can increase the scope of P2a exposed.
Conclusion 1.The structures of the mesial temporal lobe are adjacent to MCA,AChA,brain stem,optic tract and BV,so understanding of the mesial temporal lobeanatomy and the relationships between the mesial temporal lobe and its surroundingstructures is conducive to the microsurgical operations of the mesial temporal lobelesions.Inferior choroidal point,choroidal fissure,the characteristic of the posteriorportion of the amygdala fused with the hippocampul head,are the important surgicallandmarks.2.Dividing the medial temporal region into smaller areas allows for amore precise analysis,not only of the expected anatomic relationships,but also of thepossible choices for the safe resection of the lesion.3.Each approach to medialtemporal lesions has technical or functional drawbacks and combination ofapproaches that should be considered when selecting a surgical treatment for a givenpatient.4.Partial resection of uncus may be used as a method to expose the anteriorportion of medial temporal region.
引文
1.Wen HT,Rhoton AL Jr,de Oliveira E,et al.Microsurgical anatomy of the temporal lobe:Part 1:Mesial temporal lobe anatomy and its vascular relationships as applied to amygdalohippocampectomy[J].Neurosurgery,1999,45.549-592.
2．陈玉敏．海马的解剖定位研究[J]．功能性和立体定向神经外科杂志，1994，17(3)：1-2．
3．刘绍明．颞叶叶外科的应用解剖学[J]．国外医学神经病学神经外科学分册，1995，22(3)：134-137．
4.Duvemoy HM.The human hippocampus[M].JF BergmannVerlag.1988:1-153
5．王耀志，高永中，苏芳忠．杏仁核和海马结构的显微外科解剖[J]．功能性和立体定向神经外科杂志，1998，11(2)：5-7．
6.Naidich TP.The hippocampal formation:anatomic-MR correlation.Part1.Surface features and coronal sections[J].Radiology,1987,162:747-754.
7.Bouthillier A,van Loveren HR,Keller JT.Segments of the internal carotid artery:a new classification[J].Neurosurgery,1996,3 8(3):425-43 3.
8．姜中利，王忠诚，李明洲．颞叶内侧解剖及与周围结构的毗邻关系[J]．中华医学杂志，2006，86(31)：2197-2230．
9.Ulm AJ,Fautheree GL,Tanriover N,et al.Microsurgical and angiographic anatomy of middle cerebral artery aneurysms:prevalence and significance of early branch aneurysms[J].Neurosurgery,2008,62[ONS Suppl 2]:ONS344-ONS353.
10．梅镇彤．学习与己忆．神经科学纲要[M]．北京：北京医科大学中国协和医科人学联合出版社，1993，723-736．
11.Hooper MW,Vogel FS.The limbics ystem in Alzheimer's Disease[J].The American Journal of Pathology,1976,85:1-13.
12.Huesgen CT,Burger PC,Crain BJ.In vitro MR microscopy of the hippocampus in Alzheimer's Disease[J].Neurology,1993,43:145-152.
13．高旭光．颞叶癫痫与海马硬化．国外医学神经病学神经外科学分册[J]．1993，20(2)：58-60．
14．周志韶，谭启富，周晓军．70例颞叶癫痫的病理与临床研究[J]．功能性和立 Ophthalmol,2000,84:884-889.
44.Sincof EH,Tan Y.White mater fiber dissection of the optic radiations of file temporal lobe and imphcafions for surgical approaches to the temporal hom[J].J Neurosurg,2004,101(5):739-746.
45.Ebeling U,Reulen HJ.Neurosurgical topography of the optic radiation in the temporal lobe[J].Acta Neurochir (Wien),1988,92:29-36.
46.Muller J,Shaw L.Arterial vascularization of the human hippocampus[J].Arch Neurol,1965,13:45-47.
47.Nagata S,Rhoton AL Jr,Barry M.Microsurgical anatomy of the choroidal fissure[J].Surg Neurol,1988,30:3-59.
48.Ehni G,Ehni BL.Considerations in transforaminal entry:Surgery of the Third Ventricle[M].Baltimore,Williams & Wilkins,1998:391-419.
49.Garretson HD:.Memory in man:A neurosurgeon's perspective:Surgery of the Third Ventricle[M].Baltimore,Williams & Wilkins,1998:211-214.
50.Gonzalez LF,Smith KA.Meyer's loop[J].BNIQ,2001,18:4-7.
51.Heros RC.Arteriovenous malformations of the medial temporal lobe.Surgical approach and neuroradiological characterization[J].J Neurosurg,1982,56:44-52.
52.Howell DA.Upper brain-stem compression and foraminal impaction with intracranial space-occupying lesions and brain swelling[J].Brain,1959,82:525-550.
53.Sunderland S.The tentorial notch and complications produced by herniations of the brain through that aperture[J].Br J Surg,1958,45:422-438.
54．马增路．天幕裂孔切开术治疗急性重型颅脑损伤脑疝[J]．河北医药，2007，29(4)：345．
55．鲍彦春．天幕裂孔切开救治颞叶钩回疝的手术方法和经验[J]．中国现代实用医学杂志，2004．3(21、22)：50-51．
56．林合麟，陶水英，赖祝琴．天幕切开低温液基底池灌洗治疗特重型颅脑损伤的临床研究[J]．中国保健(医学研究版)，2008，16(12)：419-421．
57．赵强，何东升，王德全，等．小脑幕切开术治疗外伤性小脑幕切迹疝[J]．四川医学，2003，24(7)：673．
58．M．G Yasargil著，凌锋译．显微神经外科学Ⅰ卷[M]．北京：中国科学技术出 版社，2005：36-44．
59．佟小光，刘暌，王宏，等．颞浅动脉引导的筋膜间隙翼点入路面神经分支保护研究[J]．中国现代神经疾病杂志，2008， 8(2)：146-149．
60．魏群，郑文济，赵春平，等．翼点开颅术中面神经颞支保护新方法[J]．中国微侵袭神经外科杂志，2003，8(10)：479．
61．张力，涂汉军，朱志华，等．颞下入路的显微解剖学研究[J]．中国临床神经外科杂志，2008，13(1)：20-22．
62.Rhoton AL.The temporal bone and transtemporal approaches[J].Neurosurgery,2000,47:211-265.
63．朱军，付爱军，肖海龙．颞下锁孔入路的显微解剖研究[J]．中华神经医学杂志．2005,4(1)：35-37．
64.de Oliveira E,Siqueira M,Ono M,et al.Arteriovenous malformations of the mediobasal temporal region[J].Neurosurgeons,1992,11:349-358.
65.de Oliveira EP,Tedeschi H,Siqueira MG,et al:Anatomic principles of cerebrovascular surgery for arteriovenous malformations[J].Clin Neurosurg,1994,41:364-380.
66.Tedeschi H,de Oliveira EP,Rhoton AL Jr,et al.Microsurgical anatomy of arteriovenous malformations,in Jafar JJ,Awad IA,Rosenwasser RH (eds):Vascular Malformations of the Central Nervous System[M].Philadelphia,Lippincott,Williams & Wilkins,1999:243-259.
67.Rhoton.Tentorial incisura[J].Neurosurgery,2000,47(3):s131-153.
68.Wiebe S,Blume WT,Girvin JP,et al.Effectiveness and efficiency of surgery for temporal lobe epilepsy study group:arandomized,controlled trial of surgery for temporal lobe epilepsy[J].N Engl J Med,2001,345:311-318.
69.Foldvary N,Nashold B,Mascha E,et al.Seizure outcome after temporal lobectomy for temporal lobe epilepsy:a Kaplan-Meier survival analysis[J].Neurology,2000,54:630-634.
70.Spencer S,Berg AT,Vickrey BG,et al.Predicting long-term seizure outcome after resective epilepsy surgery:the multicenter study[J].Neurology,2005,65:912-918.
71.Yasargil MG,Wieser HG,Valavanis A,et sl.Surgery and results of selective amygdala-hippocampectomy in one hundred patients with nonlesional limbic epilepsy[J].Neurosurg Clin N Am,1993,4:243-261.
72.Morino M,Uda T,Naito K,et al.Comparison of neuropsychological outcomes after selective arnygdalohippocampectomy versus anterior temporal lobectomy.Epilepsy Behav,2000,9:95-100.
73.Tanriverdi T,Olivier A,Poulin N,et al.Long-term seizure outcome after mesial temporal lobe epilepsy surgery:corticalamygdalohippocampectomy versus selective amygdalohippocampectomy[J].J Neurosurg,2008,108:517-524.
74.Paglioli E,Palmini A,Portuguez M,et al.Seizure and memory outcome following temporal lobe surgery:selective compared with nonselective approaches for hippocampal sclerosis[J].J Neurosurg,2006,104:70-78.
75.Yasargil MG,Teddy P J,Roth P.Selective amygdalo-hippocampectomy.Operative anatomy and surgical technique[J].Adv Tech Stand Neurosurg,1985,12:93-123.
76．M．G亚萨吉尔著，凌锋主译．显微神经外科学ⅣB卷[M]．北京：中国科学技术出版社，2007： 271．
77.Campero A,Troccoli G,Martins C,et al.Microsurgical approaches to the medialtemporal region:an anatomical study[J].Neurosurgery,2006,59[ONS Suppl 4]:ONS-279-ONS-308.
78.Helmstaedter C,Richter S,Roske S,et al.Differential effects of temporal pole resection with amygdalohippocampectomy versus selective amygdalohippocarnpectomy on material-specific memory in patients with mesial temporal lobe epilepsy[J].Epilepsia,2008,49:88-97.
79.Choi C,Rubino PA,Fernandez-Miranda JC,et al.Meyer's loop and the optic radiations in the transsylvian approach to the mediobasal temporal lobe[J].Neurosurgery,2006,59(4 Suppl 2):ONS228-236.
80.Yasargil MG,Ture U,Yasargil DC:Impact of temporal lobe surgery[J].J Neurosurg,2004,101 (5):725-38.
81.Yasargil MG,von Ammon K,Cavazos E,et al.tumours of the limbic and paralimbic systems[J].Acta Neurochir,1992,118:40-52.
82.Vajkoczy P,Krakow K,Stodieck S,et al.Modified approach for the selective treatment of temporal lobe epilepsy:transsylvian-transcisternal mesial en bloc resection[J].J Neurosurg,1998,88:855-862.
83.Wyler AR.Anterior temporal lobectomy[J].Surg Neurol,2000,54:341-345.
84.Spencer DD.Anteromedial temporal lobectomy:directing the surgical approach to the pathologic substriate,in Spencer SS,Spencer DD(eds):surgery for epilepsy[M].Boston,Blackwell Scientific Publications,1991:129-137.
85．陶存山，楼美清，卢亦成，等．脉络裂颞部在选择性海马杏仁切除中的解剖学意义[J]．实用医学杂志，2005，21(12)：1283-1284．
86.Luders H,Lesser RP,Hahn J,et al.Basal temporal language area[J].Brain,1991,114:743-754.
87.Du R,Young WL,Lawton MT.“Tangential” resection of medial temporal lobe arteriovenous malformations with the orbitozygomatic approach[J].Neurosurgery,2004,54:645-652.
88.Kopema TH,Tshabitscher M,Knosp E.The termination of the vein of Labb(?) and its microsurgical significance[J].Acta Neurochir(W ien),1992,118:172-175.
89.DiChiro G..Angiographic patterns of cerebral convexity veins and superficial dural sinuses[J].A JR Am J Rocntgenol,1962,87:308-321.
90.Oka K,RhotonA L Jr,Barry M,et al.M icrosurgicala natomy of the superficial veins of the cerebrum[J].Neurosurgery,1985,17(5):711-748.
91．张力伟，王忠诚，于春江，等．Labb(?)静脉的显微解剖学研究[J]．中华神经外科杂志，2003，19：456-458．
92.Guppy KH,Origitan T,Reichman OH,et al.Venous drainage of the inferolateral temporal lobe in relationship to transtemporal/transtentorial approaches to the cran ial base[J].Neurosurgery,1997,4.615-620.
93.Rhoton AL J r.The cerebral veins[J].Neurosurgery,2002,51:159-205.
94．张岩松，常义，惠国桢，等．颞叶桥静脉引流形式的显微外科解剖研究[J]．中华神经外科杂志，2005，21(1)：9-13．
95.McKinnon SG..Anatomy of the cerebral veins,dural sinuses,sella meninges,and CSF spaces[J].Neuroimaging Clin N Am,1998,8:101-117.
96.Sugita K,Kobayashi S,Yokoo A.Preservation of large bridging veins during brain retraction[J].J Neurosurg,1982,57:856-858.
97．张岩松，邵君飞，常义，等．幕上下联合经部分迷路岩尖入路的显微解剖研究[J]．中国微侵袭神经外科杂志，2003，8：266-269．
98.Morita A,Sekhar LN.Reconstruction of the vein of Labb(?) by using a short saphenous vein bypass graft.Technical note[J].J Neurosurg,1998,89(4):671-675.
99.Voigt K,Yasargil MG..Cerebral cavernous hemangiomas or cavernomas:Incidence,pathology,localization,diagnosis,clinical features and treatment.Review of the literature and report of an unusual case[J].Neurochirurgia (Stuttg),1976,19:59-68.
100.Yonekawa Y,Imhof HG,Taub E,et al.Supracerebellar transtentorial approach to posterior temporomedial structures.Technical note[J].J Neurosurg,2001,94:339-345.
101．申长虹，松果体区显微外科解剖[J]．中国现代神经疾病杂志，2003，1，37-40．
102.Shaw EG,WisoffJH.Prospective clinical trials of intracranial low-grade glioma in adults and children[J],Neuro-oncol,2003,5(3):153-160.
103.Keles GE,Lalmbom KR,Berger MS.Low-grade hemispheric gliomas in adults:a critical review of extent of resection as a factor influencing outcome[J].J Neurosurg,2001,95(5):735-745.
104.Stupp R,Janzer RC,neo ME,et al.Prognostic factors for low-grade gliomas[J].Semin Oncol,2003,30(Suppl19):23-28.
105.Bampoe J,Bemstein M.The role of surgefy in low grade gliomas[J].J Neuro-oncolngy,1999,42(3):259-26.
106.Shaw EG,Tater SB,Lesser GJ,et al.Current controversies in the radiothempeutic management of adult low grade glioma[J].Semin Oncol,2004,31(5):653-658.
107.Fried I,Kim JH,Spencer DD.Limbic and neocortical gliomas associated with intractable seizures:A distinct clinicopathological group[J].Neurosurgery,1994,34:815-823.
108.Fish D,Andermann F,Olivier A.Complex partial seizures and small posterior temporal or extratemporal structural lesions:Surgical management[J].Neurology,199141:1781-1784.
109.Clusmann H,Kral T,Fackeldey E,et al.Lesional mesial temporal lobe epilepsy and limited resections:Prognostic factors and outcome[J].J Neurol Neurosurg Psychiatry,2004,75:1589-1596.
110.Russell SM,Kelly PJ.Volumetric stereotaxy and the supratentorial occipitosubtemporal approach in the resection of posterior hippocampus and parahippocampal gyrus lesions[J].Neurosurgery,2002,50:978-988.
111.Ture U,Pamir MN.Small petrosal approach to the middle portion of the mediobasal temporal region:Technical case report[J].Surg Neurol,2004,61:60-67.
112．M．G亚萨吉尔著，凌锋主译．显微神经外科学ⅣB卷[M]．北京：中国科学技术出版社，2007：271-294．
113．姜中利，王忠诚，江涛．不同手术入路切除颞叶内侧胶质瘤的手术效果[J]．中华医学杂志，2005，85(34)：2428-2432．
114.Schramm J,Aliashkevich AF.Surgery for temporal mediobasal tumors:experience based on a series of 235 patients[J].Neurosurgery,2007,60:285-295.
115.Abdulrauf SI,Yasargil MG.Surgery for temporal mediobasal tumors:experience based on a series of 235 patients[J].Comments.Neurosurgery,2007,60:294-295.
116.Jooma R,Yeh H,Privitera MD,et al.Lesionectomy versus electrophysiologically guided resection for temporal lobe tumors manifesting with complex partial seizures[J].JNeurosurg,1995,83:231-236.
117.Lombardi D,Marsh R,Tribolet N.Low grade glioma in intractable epilepsy:lesionectomy versus epilepsy surgery[J].ActaNeurochir,1997,68:70-74.
118．蔡强，陈谦学，黄书岚，等．海马区肿瘤的临床病理特征及显微外科治疗[J]．中华显微外科杂志,2007，30(6)：467-468．
119.Ferrante L,Acqui M,Trillo G,et al.Aneurysms of the posterior cerebral artery:Do they present specific characteristics[J]? Acta Neurochir (Wien),1996,138:840-852.
120.Yasargil MG:Vertebrobasilar aneurysms[A],in Yasargil MG:Microneurosurgery vol Ⅱ:Clinical Considerations,Surgery of the Intracranial Aneurysms and Results[M].Stuttgart,Georg Thieme,1984:260-269.
121.Drake CG,Amacher AL.Aneurysms of the posterior cerebral artery[J].J Neurosurg, 1969,30:468-474.
122.Sakata S, Fujii K, Matsushima T, et al. Aneurysm of the posterior cerebral artery: Report of eleven cases-Surgical approaches and procedures [J]. Neurosurgery,1993,32:163-168.
123.Shunsuke T, Yutaka S, Hiroyasu K, et al. Surgical Approaches for the Treatment of Aneurysms on the P2 Segment of the Posterior Cerebral Artery[J].Neurosurgery,2000,47(2):359-366.
124.Yasargil MG. Clinical Considerations, Surgery of the Intracranial Aneurysms and Results. Microneurosurgery vol Ⅱ[M].Stuttgart, Georg Thieme, 1984:260-269.
125.Teresaka S, Sawamura Y, Kamiyama H,et al. Surgical approaches for the treatment of aneurysms on the P2 segment of the posterior cerebral artery [J].Neurosurgery, 2000,47:359-365.
126.Post N, Russell SM, Jafar JJ.Role of uncal resection in optimizing transsylvian access to the basilar:cadaveric investigation and preliminary clinical experience in eight patients [J] .Neurosurgery, 2005,56[ONS Suppl 2]:ONS-274-ONS-280.
127.Post N, Russell SM, Jafar JJ.Role of uncal resection in optimizing transsylvian access to the basilancadaveric investigation and preliminary clinical experience in eight patients[J].Comments,Neurosurgery,2005,56[ONS Suppl 2]:ONS-274-ONS-280.
128.1keda K, Yamashita J, Futami K, et al. Surgical indication of the transchoroidal fissure approach for vascular lesions in and around the interpeduncular and ambient cisterns: From a surgical microanatomical study using cadaver [J]. Surg Cereb Stroke, 1995, 23:139-144.
129.Orita T, Tsurutani T, Kitahara T.P2 aneurysm approached via the temporal horn: Technical case report [J]. Neurosurgery, 1997,41:972-974.
130.Ulm AJ, Tanriover N, Kawashima M,et al. Microsurgical approaches to the perimesencephalic cisterns and related segments of the posterior cerebral arteryxomparison using a novel application of imaging guidence[J].Neurosurgery, 200454:1313-1328.
131.Heros RC. Brain resection for exposure of deep extracerebral and paraventricular lesions[J].Surg Neurol, 1990,34:188-195.
132.Malik GM, Seyfried DM, Morgan JK.Temporal lobe arteriovenous malformations: Surgical management and outcome [J].Surg Neurol,1996,46:106-115.
133.Yanaka K, Tsuboi K, Fujita K, et al. Distal anterior choroidal artery aneurysm associated with an arteriovenous malformation: Intraoperative localization and treatment[J]. Surg Neurol, 2000,53:546-551.
1. Mayanagi Y. Onset and propagation of hippocampal seizure in man[J]. Jpn J Psychiatry Neurol ,1990,44: 321-325.
2. Spencer SS, Spencer DD. Entorhinal-hippocampal interactions in medial temporal lobe epilepsy[J]. Epilepsia, 1994,35: 721-727.
3. Wyler AR, Hermann BP. Extent of medial temporal resection on outcome from anterior temporal lobectomy: A randomized prospective study [J]. Neurosurgery, 1997,41:327-328.
4. Wyler AR, Hermann BP, Somes GExtent of medial temporal resection on outcome from anterior temporal lobectomy: A randomized prospective study [J].Neurosurgery, 1995,37: 982-991.
5. Renowden SA, Matkovic Z, Adams CB, et al. Selective amygdalohippocampectomy for hippocampal sclerosis: Postoperative MR appearance[J]. AJNR Am JNeuroradiol, 1995,16: 1855-1861.
6. Yasargil MG: Microneurosurgery. AVM of the Brain-Clinical Considerations,General and Special Operative Techniques, Surgical Results, Nonoperated Cases,Cavernous and Venous Angiomas, Neuroanesthesia. Stuttgart, Georg Thieme Verlag, 1988, vol Ⅲ-B.
7. de Oliveira E, Siqueira M, Ono M, et al. Arteriovenous malformations of the mediobasal temporal region[J]. Neurosurgeons , 1992,11: 349-358.
8. Timurkaynak E, Rhoton AL Jr, Barry M. Microsurgical anatomy and operative approaches to the lateral ventricles [J]. Neurosurgery , 1986,19: 685-723.
9. Salamon G, Lecaque GL, Strother CM. An angiographic study of the temporal horn[J]. Radiology , 1978,128: 387-392.
10. Warwick R, Williams PL. Gray's Anatomy. Philadelphia, W.B. Saunders Co.,1973, ed 35.
11. Gloor P. The Temporal Lobe and Limbic System. New York, Oxford University Press, 1997.
12. Duvernoy HM, Bourgouin P. The Human Hippocampus: Functional Anatomy,Vascularization and Serial Sections with MRI. New York, Springer-Verlag, 1998, ed2.
13. Williams PL. Gray's Anatomy. London, Churchill Livingstone, 1995, ed 38.
14. Ebeling U, Reulen HJ. Neurosurgical topography of the optic radiation in the temporal lobe[J]. Acta Neurochir (Wien), 1988,92: 29-36.
15. Nagata S, Rhoton AL Jr, Barry M. Microsurgical anatomy of the choroidal fissure[J]. Surg Neurol, 1988,30: 3-59.
16. Rhoton AL Jr, Gibo H, Lenkey C. Microsurgical anatomy of the supraclinoid portion of the internal carotid artery[J]. J Neurosurg, 1981,55: 560-574.
17. Hussein S, Renella RR, Dietz H. Microsurgical anatomy of the anterior choroidal artery[J]. Acta Neurochir (Wien), 1988,92: 19-28.
18. Yasargil MG: Microneurosurgery. Microsurgical Anatomy of the Basal Cisterns and Vessels of the Brain, Diagnostic Studies, General Operative Techniques and Pathological Considerations of the Intracranial Aneurysms. Stuttgart, Georg Thieme Verlag, 1984, vol Ⅰ.
19. Marinkovic S, Milisavljevic M, Puskas L. Microvascular anatomy of the hippocampal formation[J]. SurgNeurol, 1992, 37: 339-349.
20. Erdem A, Yasargil MG, Roth P. Microsurgical anatomy of the hippocampal arteries[J]. J Neurosurg, 1993,79: 256-265.
21. Yasargil MG, Wieser HG, Valavanis A, et al. Surgery and results of selective amygdala: Hippocampectomy in one hundred patients with nonlesional limbic epilepsy[J]. Neurosurg Clin N Am , 1993,4: 243-261.
22. Huang YP, Wolf BS. The basal cerebral vein and its tributaries, in Newton TH, Potts DG (eds): Radiology of the Skull and Brain. St. Louis, C.V. Mosby, 1971,vol 2, book 3,2111-2154.
23. de Oliveira EP, Tedeschi H, Siqueira MG, et al. Anatomic principles of cerebrovascular surgery for arteriovenous malformations[J]. Clin Neurosurg,1994,41:364-380.
24. Tedeschi H, de Oliveira EP, Rhoton AL Jr, et al. Microsurgical anatomy of arteriovenous malformations, in Jafar JJ, Awad IA, Rosen wasser RH (eds):Vascular Malformations of the Central Nervous System. Philadelphia,Lippincott,Williams & Wilkins, 1999, 243-259.
25. Yasargil MG, Teddy PJ, Roth P.Selective amygdalo-hippocampectomy. perative anatomy and surgical technique[J]. Adv Tech Stand Neurosurg, 1985,12:93-123.
26. Campero Alvaro, Troccoli Gustavo, Martins Carolina,et al.Microsurgical approaches to the medialtemporal region: an anatomical study[J]. Neurosurgery,2006 ,59[ONS Suppl 4]:ONS-279-ONS-308.
27. Choi C, Rubino PA, Fernandez-Miranda JC,et al.Meyer's Loop and the Optic Radiations in the Transsylvian Approach to the Mediobasal Temporal Lobe[J].Neurosurgery, ,2006,59(4 Suppl 2): ONS228-236.
28. Rubino PA, Rhoton AL Jr, X Tong, et al.Three-dimensional relationships of the optic radiation[J]. Neurosurgery, 2005,57(4 Suppl): 219-27; discussion 219-227.
29. Yasargil MG, Ture U, Yasargil DC. Impact of temporal lobe surgery[J].J Neurosurg, 2004,101(5): 725-38.
30. Yasargil MG,von Ammon K,Cavazos E,et al.tumours of the limbic and paralimbic sy stems [J].Acta Neurochir, 1992,118:40-52.
31. Miyagi Y,Shima F,Ishido K,et al.Inferior temporal sulcus approach for amygdalohippocampectomy guided by a laser beam of stereotectic navigator[J] .Neurosurgery, 2003,52:1117-1124.
32. Wyler AR.Anterior temporal lobectomy[J].Surg Neurol, 2000,54:341-345.
33. Spencer DD: Anteromedial temporal lobectomy:directing the surgical approach to the pathologic substriate, in Spencer SS, Spencer DD(eds):surgery for epilepsy.Boston,Blackwell Scientific Publications, 1991,129-137.
34. Wen HT, Rhoton AL Jr, de Oliveira EP, et al. Microsurgical anatomy of the temporal lobe: Part 1. Medial temporal lobe anatomy and its vascular relationships as applied to amygdalohippocampectomy[J]. Neurosurgery ,1999,45:549-592.
35. Park TS,Bourgeois BFD, Silbergeld DL,et al.Subtemporal transparahippocampal amygdalohippocampectomy for surgical treatment of mesial temporal lobe epilepsy[J].J Neurosurg, 1996,85:1172-1176.
36. Hori T, Tabuchi S, Kurosaki M, et al. Subtemporal amygdalohippocampectomy for treating medically intractable temporal lobe epilepsy[J]. Neurosurgery,1993,33:50-57.
37. Miyamoto S, Kataoka H, Ikeda A, et al. A combined subtemporal and transventricular/transchoroidal fissure approach to medial temporal lesions [J].Neurosurgery , 2004,54:1162-1169.
38. Sincoff EH, Tan Y, Abdulrauf SI. White matter fiber dissection of the optic radiations of the temporal lobe and implications for surgical approaches to the temporal horn[J]. J Neurosurg , 2004,101:725-738.
39. Luders H, Lesser RP, Hahn J, et al. Basal temporal language area[J]. Brain , 1991,114:743-754.
40. Vajkoczy P, Krakow K, Stodieck S, et al. Modified approach for the selective treatment of temporal lobe epilepsy: Transsylvian-transcistemal medial en bloc resection[J]. J Neurosurg , 1998,88:855-862.
41. DuR, Young WL, Lawton MT. "Tangential" resection of medial temporal lobe arteriovenous malformations with the orbitozygomatic approach[J]. Neurosurgery,2004, 54:645-652.
42. de Oliveira EP, Siqueira M, Ono M, et al.Arteriovenous malformations of the mediobasal temporal region. Proceedings of The Japanese Congress of Neurological Surgeons, Chiba, Japan, 1991. Neurosurgeons, 1992,11:349-358.
43. Smith KA, Spetzler RF.Supratentorial-infraoccipital approach for posteromedial temporal lobe lesions[J]. J Neurosurg, 1995,82:940-944.
44. Voigt K, Yasargil MG: Cerebral cavernous hemangiomas or cavernomas:Incidence, pathology, localization, diagnosis, clinical features and treatment.Review of the literature and report of an unusual case[J]. Neurochirurgia (Stuttg),1976,19:59-68.
45. Yonekawa Y, Imhof HG, Taub E, et al. Supracerebellar transtentorial approach to posterior temporomedial structures[J]. Technical note. J Neurosurg,2001,94:339-345
46. Spencer DD, Spencer SS, Mattson RH, et al. Access to the posterior medial temporal lobe structures in the surgical treatment of temporal lobe epilepsy [J].Neurosurgery, 1984,15:667-671.
47. Ulm AJ, Tanriover N, Kawashima M, et al: Microsurgical approaches to the perimesencephalic cisterns and related segments of the posterior cerebral artery: Comparison using a novel application of image guidance[J]. Neurosurgery, 2004,54:1313-1328.
2．陈玉敏．海马的解剖定位研究[J]．功能性和立体定向神经外科杂志，1994，17(3)：1-2．
3．刘绍明．颞叶叶外科的应用解剖学[J]．国外医学神经病学神经外科学分册，1995，22(3)：134-137．
4.Duvemoy HM.The human hippocampus[M].JF BergmannVerlag.1988:1-153
5．王耀志，高永中，苏芳忠．杏仁核和海马结构的显微外科解剖[J]．功能性和立体定向神经外科杂志，1998，11(2)：5-7．
6.Naidich TP.The hippocampal formation:anatomic-MR correlation.Part1.Surface features and coronal sections[J].Radiology,1987,162:747-754.
7.Bouthillier A,van Loveren HR,Keller JT.Segments of the internal carotid artery:a new classification[J].Neurosurgery,1996,3 8(3):425-43 3.
8．姜中利，王忠诚，李明洲．颞叶内侧解剖及与周围结构的毗邻关系[J]．中华医学杂志，2006，86(31)：2197-2230．
9.Ulm AJ,Fautheree GL,Tanriover N,et al.Microsurgical and angiographic anatomy of middle cerebral artery aneurysms:prevalence and significance of early branch aneurysms[J].Neurosurgery,2008,62[ONS Suppl 2]:ONS344-ONS353.
10．梅镇彤．学习与己忆．神经科学纲要[M]．北京：北京医科大学中国协和医科人学联合出版社，1993，723-736．
11.Hooper MW,Vogel FS.The limbics ystem in Alzheimer's Disease[J].The American Journal of Pathology,1976,85:1-13.
12.Huesgen CT,Burger PC,Crain BJ.In vitro MR microscopy of the hippocampus in Alzheimer's Disease[J].Neurology,1993,43:145-152.
13．高旭光．颞叶癫痫与海马硬化．国外医学神经病学神经外科学分册[J]．1993，20(2)：58-60．
14．周志韶，谭启富，周晓军．70例颞叶癫痫的病理与临床研究[J]．功能性和立 Ophthalmol,2000,84:884-889.
44.Sincof EH,Tan Y.White mater fiber dissection of the optic radiations of file temporal lobe and imphcafions for surgical approaches to the temporal hom[J].J Neurosurg,2004,101(5):739-746.
45.Ebeling U,Reulen HJ.Neurosurgical topography of the optic radiation in the temporal lobe[J].Acta Neurochir (Wien),1988,92:29-36.
46.Muller J,Shaw L.Arterial vascularization of the human hippocampus[J].Arch Neurol,1965,13:45-47.
47.Nagata S,Rhoton AL Jr,Barry M.Microsurgical anatomy of the choroidal fissure[J].Surg Neurol,1988,30:3-59.
48.Ehni G,Ehni BL.Considerations in transforaminal entry:Surgery of the Third Ventricle[M].Baltimore,Williams & Wilkins,1998:391-419.
49.Garretson HD:.Memory in man:A neurosurgeon's perspective:Surgery of the Third Ventricle[M].Baltimore,Williams & Wilkins,1998:211-214.
50.Gonzalez LF,Smith KA.Meyer's loop[J].BNIQ,2001,18:4-7.
51.Heros RC.Arteriovenous malformations of the medial temporal lobe.Surgical approach and neuroradiological characterization[J].J Neurosurg,1982,56:44-52.
52.Howell DA.Upper brain-stem compression and foraminal impaction with intracranial space-occupying lesions and brain swelling[J].Brain,1959,82:525-550.
53.Sunderland S.The tentorial notch and complications produced by herniations of the brain through that aperture[J].Br J Surg,1958,45:422-438.
54．马增路．天幕裂孔切开术治疗急性重型颅脑损伤脑疝[J]．河北医药，2007，29(4)：345．
55．鲍彦春．天幕裂孔切开救治颞叶钩回疝的手术方法和经验[J]．中国现代实用医学杂志，2004．3(21、22)：50-51．
56．林合麟，陶水英，赖祝琴．天幕切开低温液基底池灌洗治疗特重型颅脑损伤的临床研究[J]．中国保健(医学研究版)，2008，16(12)：419-421．
57．赵强，何东升，王德全，等．小脑幕切开术治疗外伤性小脑幕切迹疝[J]．四川医学，2003，24(7)：673．
58．M．G Yasargil著，凌锋译．显微神经外科学Ⅰ卷[M]．北京：中国科学技术出 版社，2005：36-44．
59．佟小光，刘暌，王宏，等．颞浅动脉引导的筋膜间隙翼点入路面神经分支保护研究[J]．中国现代神经疾病杂志，2008， 8(2)：146-149．
60．魏群，郑文济，赵春平，等．翼点开颅术中面神经颞支保护新方法[J]．中国微侵袭神经外科杂志，2003，8(10)：479．
61．张力，涂汉军，朱志华，等．颞下入路的显微解剖学研究[J]．中国临床神经外科杂志，2008，13(1)：20-22．
62.Rhoton AL.The temporal bone and transtemporal approaches[J].Neurosurgery,2000,47:211-265.
63．朱军，付爱军，肖海龙．颞下锁孔入路的显微解剖研究[J]．中华神经医学杂志．2005,4(1)：35-37．
64.de Oliveira E,Siqueira M,Ono M,et al.Arteriovenous malformations of the mediobasal temporal region[J].Neurosurgeons,1992,11:349-358.
65.de Oliveira EP,Tedeschi H,Siqueira MG,et al:Anatomic principles of cerebrovascular surgery for arteriovenous malformations[J].Clin Neurosurg,1994,41:364-380.
66.Tedeschi H,de Oliveira EP,Rhoton AL Jr,et al.Microsurgical anatomy of arteriovenous malformations,in Jafar JJ,Awad IA,Rosenwasser RH (eds):Vascular Malformations of the Central Nervous System[M].Philadelphia,Lippincott,Williams & Wilkins,1999:243-259.
67.Rhoton.Tentorial incisura[J].Neurosurgery,2000,47(3):s131-153.
68.Wiebe S,Blume WT,Girvin JP,et al.Effectiveness and efficiency of surgery for temporal lobe epilepsy study group:arandomized,controlled trial of surgery for temporal lobe epilepsy[J].N Engl J Med,2001,345:311-318.
69.Foldvary N,Nashold B,Mascha E,et al.Seizure outcome after temporal lobectomy for temporal lobe epilepsy:a Kaplan-Meier survival analysis[J].Neurology,2000,54:630-634.
70.Spencer S,Berg AT,Vickrey BG,et al.Predicting long-term seizure outcome after resective epilepsy surgery:the multicenter study[J].Neurology,2005,65:912-918.
71.Yasargil MG,Wieser HG,Valavanis A,et sl.Surgery and results of selective amygdala-hippocampectomy in one hundred patients with nonlesional limbic epilepsy[J].Neurosurg Clin N Am,1993,4:243-261.
72.Morino M,Uda T,Naito K,et al.Comparison of neuropsychological outcomes after selective arnygdalohippocampectomy versus anterior temporal lobectomy.Epilepsy Behav,2000,9:95-100.
73.Tanriverdi T,Olivier A,Poulin N,et al.Long-term seizure outcome after mesial temporal lobe epilepsy surgery:corticalamygdalohippocampectomy versus selective amygdalohippocampectomy[J].J Neurosurg,2008,108:517-524.
74.Paglioli E,Palmini A,Portuguez M,et al.Seizure and memory outcome following temporal lobe surgery:selective compared with nonselective approaches for hippocampal sclerosis[J].J Neurosurg,2006,104:70-78.
75.Yasargil MG,Teddy P J,Roth P.Selective amygdalo-hippocampectomy.Operative anatomy and surgical technique[J].Adv Tech Stand Neurosurg,1985,12:93-123.
76．M．G亚萨吉尔著，凌锋主译．显微神经外科学ⅣB卷[M]．北京：中国科学技术出版社，2007： 271．
77.Campero A,Troccoli G,Martins C,et al.Microsurgical approaches to the medialtemporal region:an anatomical study[J].Neurosurgery,2006,59[ONS Suppl 4]:ONS-279-ONS-308.
78.Helmstaedter C,Richter S,Roske S,et al.Differential effects of temporal pole resection with amygdalohippocampectomy versus selective amygdalohippocarnpectomy on material-specific memory in patients with mesial temporal lobe epilepsy[J].Epilepsia,2008,49:88-97.
79.Choi C,Rubino PA,Fernandez-Miranda JC,et al.Meyer's loop and the optic radiations in the transsylvian approach to the mediobasal temporal lobe[J].Neurosurgery,2006,59(4 Suppl 2):ONS228-236.
80.Yasargil MG,Ture U,Yasargil DC:Impact of temporal lobe surgery[J].J Neurosurg,2004,101 (5):725-38.
81.Yasargil MG,von Ammon K,Cavazos E,et al.tumours of the limbic and paralimbic systems[J].Acta Neurochir,1992,118:40-52.
82.Vajkoczy P,Krakow K,Stodieck S,et al.Modified approach for the selective treatment of temporal lobe epilepsy:transsylvian-transcisternal mesial en bloc resection[J].J Neurosurg,1998,88:855-862.
83.Wyler AR.Anterior temporal lobectomy[J].Surg Neurol,2000,54:341-345.
84.Spencer DD.Anteromedial temporal lobectomy:directing the surgical approach to the pathologic substriate,in Spencer SS,Spencer DD(eds):surgery for epilepsy[M].Boston,Blackwell Scientific Publications,1991:129-137.
85．陶存山，楼美清，卢亦成，等．脉络裂颞部在选择性海马杏仁切除中的解剖学意义[J]．实用医学杂志，2005，21(12)：1283-1284．
86.Luders H,Lesser RP,Hahn J,et al.Basal temporal language area[J].Brain,1991,114:743-754.
87.Du R,Young WL,Lawton MT.“Tangential” resection of medial temporal lobe arteriovenous malformations with the orbitozygomatic approach[J].Neurosurgery,2004,54:645-652.
88.Kopema TH,Tshabitscher M,Knosp E.The termination of the vein of Labb(?) and its microsurgical significance[J].Acta Neurochir(W ien),1992,118:172-175.
89.DiChiro G..Angiographic patterns of cerebral convexity veins and superficial dural sinuses[J].A JR Am J Rocntgenol,1962,87:308-321.
90.Oka K,RhotonA L Jr,Barry M,et al.M icrosurgicala natomy of the superficial veins of the cerebrum[J].Neurosurgery,1985,17(5):711-748.
91．张力伟，王忠诚，于春江，等．Labb(?)静脉的显微解剖学研究[J]．中华神经外科杂志，2003，19：456-458．
92.Guppy KH,Origitan T,Reichman OH,et al.Venous drainage of the inferolateral temporal lobe in relationship to transtemporal/transtentorial approaches to the cran ial base[J].Neurosurgery,1997,4.615-620.
93.Rhoton AL J r.The cerebral veins[J].Neurosurgery,2002,51:159-205.
94．张岩松，常义，惠国桢，等．颞叶桥静脉引流形式的显微外科解剖研究[J]．中华神经外科杂志，2005，21(1)：9-13．
95.McKinnon SG..Anatomy of the cerebral veins,dural sinuses,sella meninges,and CSF spaces[J].Neuroimaging Clin N Am,1998,8:101-117.
96.Sugita K,Kobayashi S,Yokoo A.Preservation of large bridging veins during brain retraction[J].J Neurosurg,1982,57:856-858.
97．张岩松，邵君飞，常义，等．幕上下联合经部分迷路岩尖入路的显微解剖研究[J]．中国微侵袭神经外科杂志，2003，8：266-269．
98.Morita A,Sekhar LN.Reconstruction of the vein of Labb(?) by using a short saphenous vein bypass graft.Technical note[J].J Neurosurg,1998,89(4):671-675.
99.Voigt K,Yasargil MG..Cerebral cavernous hemangiomas or cavernomas:Incidence,pathology,localization,diagnosis,clinical features and treatment.Review of the literature and report of an unusual case[J].Neurochirurgia (Stuttg),1976,19:59-68.
100.Yonekawa Y,Imhof HG,Taub E,et al.Supracerebellar transtentorial approach to posterior temporomedial structures.Technical note[J].J Neurosurg,2001,94:339-345.
101．申长虹，松果体区显微外科解剖[J]．中国现代神经疾病杂志，2003，1，37-40．
102.Shaw EG,WisoffJH.Prospective clinical trials of intracranial low-grade glioma in adults and children[J],Neuro-oncol,2003,5(3):153-160.
103.Keles GE,Lalmbom KR,Berger MS.Low-grade hemispheric gliomas in adults:a critical review of extent of resection as a factor influencing outcome[J].J Neurosurg,2001,95(5):735-745.
104.Stupp R,Janzer RC,neo ME,et al.Prognostic factors for low-grade gliomas[J].Semin Oncol,2003,30(Suppl19):23-28.
105.Bampoe J,Bemstein M.The role of surgefy in low grade gliomas[J].J Neuro-oncolngy,1999,42(3):259-26.
106.Shaw EG,Tater SB,Lesser GJ,et al.Current controversies in the radiothempeutic management of adult low grade glioma[J].Semin Oncol,2004,31(5):653-658.
107.Fried I,Kim JH,Spencer DD.Limbic and neocortical gliomas associated with intractable seizures:A distinct clinicopathological group[J].Neurosurgery,1994,34:815-823.
108.Fish D,Andermann F,Olivier A.Complex partial seizures and small posterior temporal or extratemporal structural lesions:Surgical management[J].Neurology,199141:1781-1784.
109.Clusmann H,Kral T,Fackeldey E,et al.Lesional mesial temporal lobe epilepsy and limited resections:Prognostic factors and outcome[J].J Neurol Neurosurg Psychiatry,2004,75:1589-1596.
110.Russell SM,Kelly PJ.Volumetric stereotaxy and the supratentorial occipitosubtemporal approach in the resection of posterior hippocampus and parahippocampal gyrus lesions[J].Neurosurgery,2002,50:978-988.
111.Ture U,Pamir MN.Small petrosal approach to the middle portion of the mediobasal temporal region:Technical case report[J].Surg Neurol,2004,61:60-67.
112．M．G亚萨吉尔著，凌锋主译．显微神经外科学ⅣB卷[M]．北京：中国科学技术出版社，2007：271-294．
113．姜中利，王忠诚，江涛．不同手术入路切除颞叶内侧胶质瘤的手术效果[J]．中华医学杂志，2005，85(34)：2428-2432．
114.Schramm J,Aliashkevich AF.Surgery for temporal mediobasal tumors:experience based on a series of 235 patients[J].Neurosurgery,2007,60:285-295.
115.Abdulrauf SI,Yasargil MG.Surgery for temporal mediobasal tumors:experience based on a series of 235 patients[J].Comments.Neurosurgery,2007,60:294-295.
116.Jooma R,Yeh H,Privitera MD,et al.Lesionectomy versus electrophysiologically guided resection for temporal lobe tumors manifesting with complex partial seizures[J].JNeurosurg,1995,83:231-236.
117.Lombardi D,Marsh R,Tribolet N.Low grade glioma in intractable epilepsy:lesionectomy versus epilepsy surgery[J].ActaNeurochir,1997,68:70-74.
118．蔡强，陈谦学，黄书岚，等．海马区肿瘤的临床病理特征及显微外科治疗[J]．中华显微外科杂志,2007，30(6)：467-468．
119.Ferrante L,Acqui M,Trillo G,et al.Aneurysms of the posterior cerebral artery:Do they present specific characteristics[J]? Acta Neurochir (Wien),1996,138:840-852.
120.Yasargil MG:Vertebrobasilar aneurysms[A],in Yasargil MG:Microneurosurgery vol Ⅱ:Clinical Considerations,Surgery of the Intracranial Aneurysms and Results[M].Stuttgart,Georg Thieme,1984:260-269.
121.Drake CG,Amacher AL.Aneurysms of the posterior cerebral artery[J].J Neurosurg, 1969,30:468-474.
122.Sakata S, Fujii K, Matsushima T, et al. Aneurysm of the posterior cerebral artery: Report of eleven cases-Surgical approaches and procedures [J]. Neurosurgery,1993,32:163-168.
123.Shunsuke T, Yutaka S, Hiroyasu K, et al. Surgical Approaches for the Treatment of Aneurysms on the P2 Segment of the Posterior Cerebral Artery[J].Neurosurgery,2000,47(2):359-366.
124.Yasargil MG. Clinical Considerations, Surgery of the Intracranial Aneurysms and Results. Microneurosurgery vol Ⅱ[M].Stuttgart, Georg Thieme, 1984:260-269.
125.Teresaka S, Sawamura Y, Kamiyama H,et al. Surgical approaches for the treatment of aneurysms on the P2 segment of the posterior cerebral artery [J].Neurosurgery, 2000,47:359-365.
126.Post N, Russell SM, Jafar JJ.Role of uncal resection in optimizing transsylvian access to the basilar:cadaveric investigation and preliminary clinical experience in eight patients [J] .Neurosurgery, 2005,56[ONS Suppl 2]:ONS-274-ONS-280.
127.Post N, Russell SM, Jafar JJ.Role of uncal resection in optimizing transsylvian access to the basilancadaveric investigation and preliminary clinical experience in eight patients[J].Comments,Neurosurgery,2005,56[ONS Suppl 2]:ONS-274-ONS-280.
128.1keda K, Yamashita J, Futami K, et al. Surgical indication of the transchoroidal fissure approach for vascular lesions in and around the interpeduncular and ambient cisterns: From a surgical microanatomical study using cadaver [J]. Surg Cereb Stroke, 1995, 23:139-144.
129.Orita T, Tsurutani T, Kitahara T.P2 aneurysm approached via the temporal horn: Technical case report [J]. Neurosurgery, 1997,41:972-974.
130.Ulm AJ, Tanriover N, Kawashima M,et al. Microsurgical approaches to the perimesencephalic cisterns and related segments of the posterior cerebral arteryxomparison using a novel application of imaging guidence[J].Neurosurgery, 200454:1313-1328.
131.Heros RC. Brain resection for exposure of deep extracerebral and paraventricular lesions[J].Surg Neurol, 1990,34:188-195.
132.Malik GM, Seyfried DM, Morgan JK.Temporal lobe arteriovenous malformations: Surgical management and outcome [J].Surg Neurol,1996,46:106-115.
133.Yanaka K, Tsuboi K, Fujita K, et al. Distal anterior choroidal artery aneurysm associated with an arteriovenous malformation: Intraoperative localization and treatment[J]. Surg Neurol, 2000,53:546-551.
1. Mayanagi Y. Onset and propagation of hippocampal seizure in man[J]. Jpn J Psychiatry Neurol ,1990,44: 321-325.
2. Spencer SS, Spencer DD. Entorhinal-hippocampal interactions in medial temporal lobe epilepsy[J]. Epilepsia, 1994,35: 721-727.
3. Wyler AR, Hermann BP. Extent of medial temporal resection on outcome from anterior temporal lobectomy: A randomized prospective study [J]. Neurosurgery, 1997,41:327-328.
4. Wyler AR, Hermann BP, Somes GExtent of medial temporal resection on outcome from anterior temporal lobectomy: A randomized prospective study [J].Neurosurgery, 1995,37: 982-991.
5. Renowden SA, Matkovic Z, Adams CB, et al. Selective amygdalohippocampectomy for hippocampal sclerosis: Postoperative MR appearance[J]. AJNR Am JNeuroradiol, 1995,16: 1855-1861.
6. Yasargil MG: Microneurosurgery. AVM of the Brain-Clinical Considerations,General and Special Operative Techniques, Surgical Results, Nonoperated Cases,Cavernous and Venous Angiomas, Neuroanesthesia. Stuttgart, Georg Thieme Verlag, 1988, vol Ⅲ-B.
7. de Oliveira E, Siqueira M, Ono M, et al. Arteriovenous malformations of the mediobasal temporal region[J]. Neurosurgeons , 1992,11: 349-358.
8. Timurkaynak E, Rhoton AL Jr, Barry M. Microsurgical anatomy and operative approaches to the lateral ventricles [J]. Neurosurgery , 1986,19: 685-723.
9. Salamon G, Lecaque GL, Strother CM. An angiographic study of the temporal horn[J]. Radiology , 1978,128: 387-392.
10. Warwick R, Williams PL. Gray's Anatomy. Philadelphia, W.B. Saunders Co.,1973, ed 35.
11. Gloor P. The Temporal Lobe and Limbic System. New York, Oxford University Press, 1997.
12. Duvernoy HM, Bourgouin P. The Human Hippocampus: Functional Anatomy,Vascularization and Serial Sections with MRI. New York, Springer-Verlag, 1998, ed2.
13. Williams PL. Gray's Anatomy. London, Churchill Livingstone, 1995, ed 38.
14. Ebeling U, Reulen HJ. Neurosurgical topography of the optic radiation in the temporal lobe[J]. Acta Neurochir (Wien), 1988,92: 29-36.
15. Nagata S, Rhoton AL Jr, Barry M. Microsurgical anatomy of the choroidal fissure[J]. Surg Neurol, 1988,30: 3-59.
16. Rhoton AL Jr, Gibo H, Lenkey C. Microsurgical anatomy of the supraclinoid portion of the internal carotid artery[J]. J Neurosurg, 1981,55: 560-574.
17. Hussein S, Renella RR, Dietz H. Microsurgical anatomy of the anterior choroidal artery[J]. Acta Neurochir (Wien), 1988,92: 19-28.
18. Yasargil MG: Microneurosurgery. Microsurgical Anatomy of the Basal Cisterns and Vessels of the Brain, Diagnostic Studies, General Operative Techniques and Pathological Considerations of the Intracranial Aneurysms. Stuttgart, Georg Thieme Verlag, 1984, vol Ⅰ.
19. Marinkovic S, Milisavljevic M, Puskas L. Microvascular anatomy of the hippocampal formation[J]. SurgNeurol, 1992, 37: 339-349.
20. Erdem A, Yasargil MG, Roth P. Microsurgical anatomy of the hippocampal arteries[J]. J Neurosurg, 1993,79: 256-265.
21. Yasargil MG, Wieser HG, Valavanis A, et al. Surgery and results of selective amygdala: Hippocampectomy in one hundred patients with nonlesional limbic epilepsy[J]. Neurosurg Clin N Am , 1993,4: 243-261.
22. Huang YP, Wolf BS. The basal cerebral vein and its tributaries, in Newton TH, Potts DG (eds): Radiology of the Skull and Brain. St. Louis, C.V. Mosby, 1971,vol 2, book 3,2111-2154.
23. de Oliveira EP, Tedeschi H, Siqueira MG, et al. Anatomic principles of cerebrovascular surgery for arteriovenous malformations[J]. Clin Neurosurg,1994,41:364-380.
24. Tedeschi H, de Oliveira EP, Rhoton AL Jr, et al. Microsurgical anatomy of arteriovenous malformations, in Jafar JJ, Awad IA, Rosen wasser RH (eds):Vascular Malformations of the Central Nervous System. Philadelphia,Lippincott,Williams & Wilkins, 1999, 243-259.
25. Yasargil MG, Teddy PJ, Roth P.Selective amygdalo-hippocampectomy. perative anatomy and surgical technique[J]. Adv Tech Stand Neurosurg, 1985,12:93-123.
26. Campero Alvaro, Troccoli Gustavo, Martins Carolina,et al.Microsurgical approaches to the medialtemporal region: an anatomical study[J]. Neurosurgery,2006 ,59[ONS Suppl 4]:ONS-279-ONS-308.
27. Choi C, Rubino PA, Fernandez-Miranda JC,et al.Meyer's Loop and the Optic Radiations in the Transsylvian Approach to the Mediobasal Temporal Lobe[J].Neurosurgery, ,2006,59(4 Suppl 2): ONS228-236.
28. Rubino PA, Rhoton AL Jr, X Tong, et al.Three-dimensional relationships of the optic radiation[J]. Neurosurgery, 2005,57(4 Suppl): 219-27; discussion 219-227.
29. Yasargil MG, Ture U, Yasargil DC. Impact of temporal lobe surgery[J].J Neurosurg, 2004,101(5): 725-38.
30. Yasargil MG,von Ammon K,Cavazos E,et al.tumours of the limbic and paralimbic sy stems [J].Acta Neurochir, 1992,118:40-52.
31. Miyagi Y,Shima F,Ishido K,et al.Inferior temporal sulcus approach for amygdalohippocampectomy guided by a laser beam of stereotectic navigator[J] .Neurosurgery, 2003,52:1117-1124.
32. Wyler AR.Anterior temporal lobectomy[J].Surg Neurol, 2000,54:341-345.
33. Spencer DD: Anteromedial temporal lobectomy:directing the surgical approach to the pathologic substriate, in Spencer SS, Spencer DD(eds):surgery for epilepsy.Boston,Blackwell Scientific Publications, 1991,129-137.
34. Wen HT, Rhoton AL Jr, de Oliveira EP, et al. Microsurgical anatomy of the temporal lobe: Part 1. Medial temporal lobe anatomy and its vascular relationships as applied to amygdalohippocampectomy[J]. Neurosurgery ,1999,45:549-592.
35. Park TS,Bourgeois BFD, Silbergeld DL,et al.Subtemporal transparahippocampal amygdalohippocampectomy for surgical treatment of mesial temporal lobe epilepsy[J].J Neurosurg, 1996,85:1172-1176.
36. Hori T, Tabuchi S, Kurosaki M, et al. Subtemporal amygdalohippocampectomy for treating medically intractable temporal lobe epilepsy[J]. Neurosurgery,1993,33:50-57.
37. Miyamoto S, Kataoka H, Ikeda A, et al. A combined subtemporal and transventricular/transchoroidal fissure approach to medial temporal lesions [J].Neurosurgery , 2004,54:1162-1169.
38. Sincoff EH, Tan Y, Abdulrauf SI. White matter fiber dissection of the optic radiations of the temporal lobe and implications for surgical approaches to the temporal horn[J]. J Neurosurg , 2004,101:725-738.
39. Luders H, Lesser RP, Hahn J, et al. Basal temporal language area[J]. Brain , 1991,114:743-754.
40. Vajkoczy P, Krakow K, Stodieck S, et al. Modified approach for the selective treatment of temporal lobe epilepsy: Transsylvian-transcistemal medial en bloc resection[J]. J Neurosurg , 1998,88:855-862.
41. DuR, Young WL, Lawton MT. "Tangential" resection of medial temporal lobe arteriovenous malformations with the orbitozygomatic approach[J]. Neurosurgery,2004, 54:645-652.
42. de Oliveira EP, Siqueira M, Ono M, et al.Arteriovenous malformations of the mediobasal temporal region. Proceedings of The Japanese Congress of Neurological Surgeons, Chiba, Japan, 1991. Neurosurgeons, 1992,11:349-358.
43. Smith KA, Spetzler RF.Supratentorial-infraoccipital approach for posteromedial temporal lobe lesions[J]. J Neurosurg, 1995,82:940-944.
44. Voigt K, Yasargil MG: Cerebral cavernous hemangiomas or cavernomas:Incidence, pathology, localization, diagnosis, clinical features and treatment.Review of the literature and report of an unusual case[J]. Neurochirurgia (Stuttg),1976,19:59-68.
45. Yonekawa Y, Imhof HG, Taub E, et al. Supracerebellar transtentorial approach to posterior temporomedial structures[J]. Technical note. J Neurosurg,2001,94:339-345
46. Spencer DD, Spencer SS, Mattson RH, et al. Access to the posterior medial temporal lobe structures in the surgical treatment of temporal lobe epilepsy [J].Neurosurgery, 1984,15:667-671.
47. Ulm AJ, Tanriover N, Kawashima M, et al: Microsurgical approaches to the perimesencephalic cisterns and related segments of the posterior cerebral artery: Comparison using a novel application of image guidance[J]. Neurosurgery, 2004,54:1313-1328.