中脳の解剖と外科治療(<特集>脳室・脳幹病変の外科治療)  [in Japanese] Surgical Anatomy of the Midbrain(<SPECIAL ISSUE>Surgical Approach for Ventricular and Brain Stem Lesion)  [in Japanese]

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Abstract

中脳は,中脳水道から背側の四丘体(quadrigeminal plate)を含む中脳蓋(tectum),左右一対の大脳脚(crus cerebri),中脳蓋と大脳脚に挟まれた中脳被蓋(tegmentum)の3つに大きく分割される.基本的に手術アプローチは,中脳蓋へは,occipital transtentorial approachかinfratentorial supracerebellar approachを,中脳被蓋へは,extreme lateral supracerebellar infratentorial approachやsubtemporal approachを,大脳脚へはorbitozygomatic approachかtrans-sylvian approachを選択するが,後遺症を最小限にするために,病変が脳幹表面に顔を出している(もしくは表面に最も近い)部位から進入することが原則と考えられる.さらに,腫瘍の長軸を3次元的に理解し,手術アプローチの進入角度を合わせることが手術には重要と思われる.

Detailed knowledge of the anatomy of the midbrain is important for the surgery. The midbrain is composed of the cerebral peduncles, the tegmentum, and the tectum. The ventral midbrain and the cerebral peduncles can be reached through the transsylvian approach or the orbitozygomatic approach. The ventrolateral midbrain and the tegmentum can be reached through the extreme lateral supracerebellar infratentorial approach or the subtemporal approach. The dorsal midbrain and the tectum can be reached through either the occipital transtentorial approach or the infratentorial supracerebellar approach. To minimize surgical morbidity, it is very important to choose the best entry point for the resection.

Journal

  • Japanese Journal of Neurosurgery

    Japanese Journal of Neurosurgery 20(6), 432-437, 2011

    The Japanese Congress of Neurological Surgeons

References:  13

Codes

  • NII Article ID (NAID)
    110008662230
  • NII NACSIS-CAT ID (NCID)
    AN10380506
  • Text Lang
    JPN
  • Article Type
    REV
  • ISSN
    0917-950X
  • Data Source
    CJP  NII-ELS  J-STAGE 
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