Mukherjee Kanchan K, Salunke Pravin, Chhabra Rajesh, Adhikari Sachin, Bharti Neerja
Department of Neurosurgery, PGIMER, Chandigarh, India.
Br J Neurosurg. 2011 Feb;25(1):127-9. doi: 10.3109/02688697.2010.525265. Epub 2010 Oct 27.
Large calvarial lesions may bleed extensively during their removal. The main vascular supply to such lesions is from branches of the external carotid arteries (ECAs). Bilateral ECA embolisation has been described to reduce the vascularity, and therefore blood loss of such lesions during their surgical removal, but it is expensive and not easily available in developing countries. In addition, it is associated with significant morbidity.
A case of a large calvarial meningioma, extending across the midline is presented in which both external carotids were temporarily clamped to reduce blood loss. Blood loss was low and the complications of permanent occlusion of the arteries avoided.
This technique can be used for vascular calvarial lesions extending across the midline where embolisation is not feasible or has failed.
大型颅骨病变在切除过程中可能会大量出血。此类病变的主要血管供应来自颈外动脉（ECA）分支。已有报道称双侧ECA栓塞可减少此类病变在手术切除过程中的血管供应，从而减少出血，但该方法费用高昂，在发展中国家不易获得。此外，它还伴有显著的发病率。
本文介绍了一例大型颅骨脑膜瘤病例，该肿瘤跨越中线，术中临时夹闭双侧颈外动脉以减少出血。出血量少，避免了动脉永久性闭塞的并发症。
对于跨越中线的血管性颅骨病变，当栓塞不可行或失败时，可采用该技术。
