颞前内侧条带放置过程中的颞极桥静脉：避免并发症的一例报告
Temporopolar bridging veins during anteromedial temporal strip placement: a case report on complication avoidance.
作者信息
McGinity Michael, Patel Vaibhav, Karkar Kameel, Papanastassiou Alexander
机构信息
Department of Neurosurgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
出版信息
J Surg Case Rep. 2017 Nov 23;2017(11):rjx186. doi: 10.1093/jscr/rjx186. eCollection 2017 Nov.
INTRODUCTION
Surgery for temporal lobe epilepsy is proven to be beneficial in the treatment of medically refractory temporal lobe epilepsy. Subdural electrode strips are commonly passed in a blind fashion, allowing additional EEG coverage without requiring larger exposure. However, this increases risk of complication, specifically through vascular injury.
CASE REPORT
We present a case of a 22-year-old male with medically refractory epilepsy. During passage of an anterior medial temporal strip electrode, resistance was encountered despite multiple attempts and redirection. This strip was abandoned. During the subsequent resection operation, a large temporopolar bridging vein complex was noted and photographed precisely where we encountered resistance.
CONCLUSION
Although much frequently less encountered than paramedian subdural strips, anterior medial temporal strip subdural electrodes may indeed injure large bridging veins. As subdural strips are passed where bony exposure is minimal, potential disastrous complications may arise if extreme caution is not used.
引言
颞叶癫痫手术已被证明对药物难治性颞叶癫痫的治疗有益。硬膜下电极条通常以盲插方式置入，可在无需更大暴露范围的情况下增加脑电图监测范围。然而，这会增加并发症风险，尤其是血管损伤风险。
病例报告
我们报告一例22岁男性药物难治性癫痫患者。在前内侧颞叶条电极置入过程中，尽管多次尝试和调整方向，仍遇到阻力。该电极条被放弃。在随后的切除手术中，发现一条粗大的颞极桥静脉复合体，恰好位于我们遇到阻力的位置，并进行了精确拍照。
结论
尽管前内侧颞叶条硬膜下电极比旁正中硬膜下条遇到的情况少得多，但确实可能损伤粗大的桥静脉。由于硬膜下条是在骨暴露最小的部位置入，如果不格外小心，可能会引发潜在的灾难性并发症。
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