McNatt Sean A, Sosa Ivan J, Krieger Mark D, McComb J Gordon
Division of Neurosurgery, Children's Hospital Los Angeles, and Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
J Neurosurg Pediatr. 2011 Mar;7(3):224-8. doi: 10.3171/2010.11.PEDS09261.
The interhemispheric transcallosal approach offers an excellent surgical corridor for the treatment of deep-seated midline lesions. The approach typically requires the sacrifice of one or more middle-third superior sagittal sinus (SSS) cortical bridging veins, which introduces the risk of venous infarction and associated neurological injury. The authors studied the incidence of venous infarcts following this operative approach in a pediatric population.
The authors performed a retrospective review of surgical cases involving pediatric patients treated at the Children's Hospital Los Angeles between 1990 and 2007, in which an interhemispheric transcallosal operative procedure was performed and one or more middle-third SSS cortical bridging veins were occluded. Postoperative MR imaging studies done 1-3 days following the procedure were analyzed and compared with preoperative studies.
Sixty-three patients met the inclusion criteria. No patient developed MR imaging evidence of venous infarction.
The occlusion of one or more middle-third SSS cortical bridging veins related to the interhemispheric transcallosal approach resulted in no incidence of cerebral venous infarction in this pediatric population.
大脑半球间经胼胝体入路为治疗深部中线病变提供了一条极佳的手术通道。该入路通常需要牺牲一条或多条上矢状窦（SSS）中1/3段的皮质桥静脉，这会带来静脉梗死及相关神经损伤的风险。作者研究了在儿科患者中采用这种手术入路后静脉梗死的发生率。
作者对1990年至2007年在洛杉矶儿童医院接受治疗的儿科患者的手术病例进行了回顾性研究，这些患者接受了大脑半球间经胼胝体手术，且一条或多条上矢状窦中1/3段的皮质桥静脉被阻断。对术后1 - 3天进行的磁共振成像（MR）研究进行分析，并与术前研究进行比较。
63例患者符合纳入标准。没有患者出现静脉梗死的MR成像证据。
在该儿科患者群体中，与大脑半球间经胼胝体入路相关的一条或多条上矢状窦中1/3段皮质桥静脉的阻断未导致脑静脉梗死的发生。
