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首页> 外文期刊>Neurosurgery >Image-guided transsylvian, transinsular approach for insular cavernous angiomas.
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Image-guided transsylvian, transinsular approach for insular cavernous angiomas.

机译：岛状海绵状血管瘤的影像引导式经跨管，经岛式入路。

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OBJECTIVE: Surgical treatment of cavernomas arising in the insula is especially challenging because of the proximity to the internal capsule and lenticulostriate arteries. We present our technique of image guidance for operations on insular cavernomas and assess its clinical usefulness. METHODS: Between 1997 and 2003, with the guidance of a frameless stereotactic system (BrainLab AG, Munich, Germany), we operated on eight patients who harbored an insular cavernoma. Neuronavigation was used for 1) accurate planning of the craniotomy, 2) identification of the distal sylvian fissure, and, finally, 3) finding the exact site for insular corticotomy. Postoperative clinical and neuroradiological evaluations were performed in each patient. RESULTS: The navigation system worked properly in all eight neurosurgical patients. Exact planning of the approach and determination of the ideal trajectory of dissection toward the cavernoma was possible in every patient. All cavernomas were readily identified and completely removed by use of microsurgical techniques. No surgical complications occurred, and the postoperative course was uneventful in all patients. CONCLUSION: Image guidance during surgery for insular cavernomas provides high accuracy for lesion targeting and permits excellent anatomic orientation. Accordingly, safe exposure can be obtained because of a tailored dissection of the sylvian fissure and minimal insular corticotomy.
机译：目的：由于离内囊和细小网状动脉很近，因此手术治疗岛状海绵体瘤尤其具有挑战性。我们介绍我们的图像指导技术对岛状海绵体瘤的手术，并评估其临床实用性。方法：在1997年至2003年之间，在无框立体定向系统（BrainLab AG，慕尼黑，德国）的指导下，我们对八名患有岛状海绵体瘤的患者进行了手术。神经导航用于1）颅骨切开术的准确计划，2）远端肩yl裂的鉴定，最后3）找到岛状皮质切开术的确切部位。对每位患者进行术后临床和神经放射学评估。结果：导航系统在所有八名神经外科患者中均正常工作。可以对每位患者进行精确的方法规划，并确定朝向海绵体的理想解剖轨迹。通过使用显微外科技术，可以轻易地识别出所有海绵状瘤并将其完全去除。没有发生手术并发症，所有患者的术后过程均顺利。结论：岛状海绵体瘤的手术过程中的图像引导可提供高精确度的病变定位，并具有良好的解剖学定位。因此，由于对希尔夫裂进行了适当的解剖和最小的岛状皮质切开术，因此可以获得安全的暴露。

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