椎骨・脳底動脈動脈瘤の手術経験

概要

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Since 1972 authors have carried out direct operations on 16 cases of the basilar artery aneurysms and on 8 cases of the vertebral artery aneurysms. 22 cases (92%) could work and lead normal family lives postoperatively. There were two postoperative deaths. They were operated upon on the 4th and 5th day respectively after subarachnoid hemorrhage. In 5 cases of the basilar artery aneurysm the operations were carried out by the subtemporal approach and in 11 subsequent cases: the transsylvian approach were chosen. Generally the transsylvian approach had more advantages than the subtemporal approach in our experiences. Injury in the temporal lobe and the oculomotor nerve occured at less degree by the transsylvian approach. While the postoperative transient oculomotor nerve palsy occured in all cases of the subtemporal approach for the aneurysms of the basilar artery bifurcation, no such palsy was found in any case of the transsylvian approach even at the night of the surgery. The important maneuvours and some useful instruments for the surgery in the region were discussed.
日本脳神経外科学会の論文