脳ベラを用いない内頸動脈瘤の手術手技

概要

論文の詳細を見る
The use of self-retaining brain retractors has been considered indispensable for gaining an appropriate operative view during microneurosurgery. But their misuse might cause vital brain damage. We report a pterional approach without brain retractors to an IC-PC or an IC-Ach. unruptured aneurysm. The surgical techniques for gaining a wide operative view without brain retractors are summarized as follows: 1) Head positioning with chin slightly up (vertex down), allowing the frontal lobe to fall away from the orbital roof. 2) Wide arachnoidal dissection from the Sylvian fissure to the contralateral optic nerve. 3) A long strip of Bemsheets serve as brain retractors. 4) Our "hand-resting" operating style. A wide operative view without brain retractors contributes to the safe dissection and clipping of an IC-PC or an IC-Ach. aneurysm, preserving the parent arteries and its perforators.
日本脳卒中の外科学会の論文
2003-07-31