纵裂人路的外科策略
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摘要
目的:为经纵裂入路处理脑深部病变提供周密的外科策略,以进一步提高临床治疗效果。方法:1.在尸头上从事纵裂入路及其相关结构的显微解剖;2.研究并比较重T2加权翻转磁共振成像对纵裂区神经及血管结构的显示情况;3.回顾性分析经纵裂入路处理脑深部病变的临床治疗结果。结果与结论:1.术前通过DSA了解桥静脉的分布、侧支循环的建立及深静脉系统的构成对计划经纵裂入路十分重要;2.不同部位的病变所建立的侧支循环模式不同;3.重T2加权翻转磁共振成像能为经纵裂入路的术前策略提供更为丰富的信息;4.PC点是计划胼下型大脑前动脉远段动脉瘤外科策略的重要标志;5.熟悉纵裂入路相关的解剖和周密的术前、术中策略有助于提高脑深部病变的治疗效果。
Object. To provide thorough surgical strategies for the deep lesions by interhemispheric approaches and improve the operative outcomes of deep lesions. Methods. (1) Microsurgical anatomy of interhemispheric approaches and corresponding structures were made to adult cadaveric brains; (2)Heavily T2 weighted reversed magnetic resonance images (T2RMRI) were studied and compared about the presentation of the nerves and blood vessels in the interhemispheric fissure. (3)To analyze retrospectively clinical outcomes of deep cerebral lesions. Results and Conclusions. (1)It was very important for planning interhemispheric approaches to understand the distribution and patterns of collateral circulation of bridging veins and the organization of deep cerebral veins by DSA before surgery; (2)There were different patterns of collateral circulation of bridging veins by different lesions; (3) More information could be provided for planning interhemispheric approaches by T2RMRI. (4)The PC point was an important surgical landmark in planning the surgical strategy for treating infracallosal distal anterior cerebral artery aneurysms. (5) Familiarity with the anatomy relative to interhemispheric approaches and thorough preoperative and intraoperative surgical strategies were beneficial to improving the operative outcomes of deep lesions by interhemispheric approaches.
Object. To provide thorough surgical strategies for the deep lesions by interhemispheric approaches and improve the operative outcomes of deep lesions. Methods. (1) Microsurgical anatomy of interhemispheric approaches and corresponding structures were made to adult cadaveric brains; (2)Heavily T2 weighted reversed magnetic resonance images (T2RMRI) were studied and compared about the presentation of the nerves and blood vessels in the interhemispheric fissure. (3)To analyze retrospectively clinical outcomes of deep cerebral lesions. Results and Conclusions. (1)It was very important for planning interhemispheric approaches to understand the distribution and patterns of collateral circulation of bridging veins and the organization of deep cerebral veins by DSA before surgery; (2)There were different patterns of collateral circulation of bridging veins by different lesions; (3) More information could be provided for planning interhemispheric approaches by T2RMRI. (4)The PC point was an important surgical landmark in planning the surgical strategy for treating infracallosal distal anterior cerebral artery aneurysms. (5) Familiarity with the anatomy relative to interhemispheric approaches and thorough preoperative and intraoperative surgical strategies were beneficial to improving the operative outcomes of deep lesions by interhemispheric approaches.
引文
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