Choice of Posterior Subtemporal Transtentorial Approach for Tumor Resection in Deep Anteromedial Superior Cerebellum
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概要
- 論文の詳細を見る
The anteromedial superior cerebellar tumor can be accessed by various routes. For tumor presenting at the cerebellar surface in this region, the optimal approach remains contentious. Furthermore, which of the various routes offers the optimal approach to a tumor that is not present at the cerebellar surface but lies deep anteromedial superior cerebellum is a matter of debate. We report herein the case of a 44-year-old woman with hemangioblastoma deep within the subcortex of the anteromedial superior cerebellum. Preoperative magnetic resonance (MR) imaging and three-dimensional anisotropy contrast MR axonography using diffusion-weighted MR imaging demonstrated that the posterior subtemporal transtentorial (PSTT) approach would provide a shorter surgical corridor, minimal cerebellar split, and better preservation of nerve fibers, compared to the other approaches. Surgical tumor removal was successfully achieved using the PSTT approach. During surgery, the PSTT approach provided an operative field that enabled visualization of the proximal side of the superior cerebellar artery as the tumor feeding vessel. Although the vein of Labbe inserted just into the transverse-sigmoid junction, injury to this vein was avoided using optimal head position, cerebrospinal fluid drainage, and various devices. For patients with tumor located within the subcortex of the anteromedial superior cerebellum, the PSTT approach is recommended as an optimal surgical route. Scrupulous evaluation using preoperative neuroimaging is crucial when deciding on the surgical approach.
- 社団法人日本脳神経外科学会の論文
- 2009-01-15
著者
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OGAWA Akira
Department of Neurosurgery, Iwate Medical University School of Medicine
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OGASAWARA Kuniaki
Department of Neurosurgery, Iwate Medical University School of Medicine
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別府 高明
岩手医科大学脳神経外科
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Ogasawara Kuniaki
岩手医科大学 脳神経外科
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Ogasawara Kuniaki
Department Of Neurosurgery Iwate Medical University
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FUJIWARA Shunrou
Advanced Medical Science Center, Iwate Medical University
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KASHIMURA Hiroshi
Department of Neurosurgery, Iwate Medical University
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Kashimura Hiroshi
Department Of Neurosurgery Iwate Medical University School Of Medicine
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Kinouchi Hiroyuki
Department Of Neurosurgery Akita University School Of Medicine:department Of Neurosurgery Kohnan Hos
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BEPPU Takaaki
Department of Neurosurgery, Iwate Medical University School of Medicine
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NISHIMOTO Hideaki
Department of Applied Chemistry, Kyushu Institute of Technology
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Ogawa Akira
Department Of Neurosurgery Iwate Medical University
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HIROOKA Ryonoshin
Department of Neurosurgery, Iwate Medical University
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FUJIWARA Shunrou
Department of Neurosurgery, Iwate Medical University
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Nishimoto Hideaki
Department Of Neurosurgery Iwate Medical University
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Nishimoto Hideaki
Department Of Applied Chemistry Kyushu Institute Of Technology
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Beppu Takaaki
Department Of Neurosurgery Iwate Medical University School Of Medicine
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Beppu Takaaki
Division Of Hyperbaric Medicine Iwate Medical University
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Ogawa Akira
Department Of Neurosurgery Iwate Medical University School Of Medicine
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Fujiwara Shunrou
Advanced Medical Science Center Iwate Medical University
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Hirooka Ryonoshin
Department Of Neurosurgery Iwate Medical University
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Kinouchi Hiroyuki
Department Of Neurosurgery Akita University School Of Medicine
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Ogawa Akira
Department Of Applied Chemistry Graduate School Of Engineering The University Of Tokyo
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Kashimura Hiroshi
Department Of Neurosurgery Iwate Medical University
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Ogawa Akira
Department Of Neurosurgery Central Clinical Laboratory Iwate Medical University
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Kikuchi Haruhiko
Department Of Neurosurgery Iwate Medical University
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OGAWA Akira
Department of Neurosurgery, Iwate Medical University
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OGASAWARA Kuniaki
Department of Neurosurgery, Iwate Medical University
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KURITA Hiroki
Hokkaido University Graduate School of Medicine
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