Horiuchi Tetsuyoshi, Nitta Junpei, Nakagawa Fukuo, Hongo Kazuhiro
Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
Surg Neurol. 2009 Jul;72(1):65-8. doi: 10.1016/j.surneu.2008.02.021. Epub 2008 Apr 28.
The authors present a modified interhemispheric approach for the distal ACA aneurysm to resolve several problems including the narrow surgical corridor, the difficulty of proximal control, and the aneurysmal projection toward the surgeon.
We refined the positions of the patient's head and the surgeon. The patient's head is fixed with flexion and tilted to the contralateral side. The surgeon sits on the contralateral side of the patient and not on the cranial side.
The present approach allows the surgeon to comfortably use both hands in the horizontal operative filed, to obtain a minimum retraction of the brain, and to easily secure the proximal artery.
This modified interhemispheric approach is useful for a patient with the distal ACA aneurysm.
作者提出一种改良的经半球间入路治疗大脑前动脉（ACA）远端动脉瘤，以解决包括手术通道狭窄、近端控制困难以及动脉瘤向术者方向突出等几个问题。
我们优化了患者头部和术者的位置。患者头部固定为前屈并向对侧倾斜。术者坐在患者对侧而非头侧。
当前入路使术者能够在水平手术视野中舒适地使用双手，使大脑的牵拉最小化，并轻松地确保近端动脉的安全。
这种改良的经半球间入路对大脑前动脉远端动脉瘤患者有用。
