Kawashima Masatou, Li Xiaoyong, Rhoton Albert L, Ulm Arthur J, Oka Hidehiro, Fujii Kiyotaka
Department of Neurological Surgery, University of Florida, Gainesville, FL 32610-0265, USA.
Surg Neurol. 2006 May;65(5):436-45. doi: 10.1016/j.surneu.2005.09.033.
Managing lesions situated in the atrium of the lateral ventricle remains a challenging neurosurgical problem. The purposes of this study were to examine the microsurgical anatomy of the atrium of the lateral ventricle and the optic radiation and to define the differences in the exposure obtained by various surgical approaches.
Fifteen adult cadaveric specimens were studied using magnification x3 to x40 after perfusion of the arteries and veins with colored silicone. The microsurgical anatomy of the atrium of the lateral ventricle was examined. The relationship between the optic radiation and the atrium was studied using the white matter fiber dissection technique. Surgical approaches to the atrium of the lateral ventricle were examined in stepwise dissection.
The medial and inferior walls of the atrium were free from optic radiation fibers. Surgical approaches to the atrium of the lateral ventricle are divided into 3 routes: (1) anterior approach: transsylvian approach, (2) posterior approaches: posterior transcortical, posterior transcallosal, occipital, and supracerebellar transtentorial approaches, and (3) lateral approaches: transtemporal and subtemporal approaches.
Knowledge of the microsurgical anatomy of the atrium of the lateral ventricle and surrounding vital structures and the choice of an appropriate surgical approach will help surgeons perform safe and minimally invasive surgery.
处理位于侧脑室三角区的病变仍然是一个具有挑战性的神经外科问题。本研究的目的是研究侧脑室三角区和视辐射的显微外科解剖结构，并确定各种手术入路所获得的暴露差异。
在对15个成年尸体标本的动静脉灌注彩色硅胶后，使用3倍至40倍的放大倍数进行研究。检查侧脑室三角区的显微外科解剖结构。使用白质纤维解剖技术研究视辐射与三角区的关系。通过逐步解剖检查侧脑室三角区的手术入路。
三角区的内侧壁和下壁没有视辐射纤维。侧脑室三角区的手术入路分为3条路径：（1）前路：经外侧裂入路；（2）后路：后经皮质、后经胼胝体、枕部和小脑上幕下入路；（3）外侧路：经颞部和颞下下入路。
了解侧脑室三角区及周围重要结构的显微外科解剖知识以及选择合适的手术入路将有助于外科医生进行安全且微创的手术。
