Goldschmidt Ezequiel, Faraji Amir H, Jankowitz Brian T, Gardner Paul, Friedlander Robert M
J Neurosurg. 2019 Aug 2;133(4):1202-1209. doi: 10.3171/2019.5.JNS19297. Print 2020 Oct 1.
Near-infrared (NIR) light is commonly used to map venous anatomy in the upper extremities to gain intravenous access for line placement. In this report, the authors describe the use of a common and commercially available NIR vein finder to delineate the cortical venous anatomy prior to dural opening.During a variety of cranial approaches, the dura was directly visualized using an NIR vein finder. The NIR light source allowed for recognition of the underlying cortical venous anatomy, dural sinuses, and underlying pathology before the dura was opened. This information was considered when tailoring the dural opening. When the dura was illuminated with the NIR vein finder, the underlying cortical and sinus venous anatomy was evident and correlated with the observed cortical anatomy. The vein finder was also accurate in locating superficial lesions and pathological dural veins. A complete accordance in the findings on the pre- and post-dural opening images was observed in all cases.This simple, inexpensive procedure is readily compatible with operative room workflow, necessitates no head fixation, and offers a real-time image independent of brain shift.
近红外（NIR）光通常用于绘制上肢静脉解剖结构，以便为放置静脉导管建立静脉通路。在本报告中，作者描述了使用一种常见的市售近红外静脉探测器在打开硬脑膜之前描绘皮质静脉解剖结构。在各种开颅手术入路中，使用近红外静脉探测器直接观察硬脑膜。近红外光源能够在打开硬脑膜之前识别其下方的皮质静脉解剖结构、硬脑膜窦和潜在病变。在设计硬脑膜开口时会考虑这些信息。当用近红外静脉探测器照亮硬脑膜时，其下方的皮质和窦静脉解剖结构清晰可见，且与观察到的皮质解剖结构相关。该静脉探测器在定位浅表病变和病理性硬脑膜静脉方面也很准确。在所有病例中，硬脑膜打开前后的图像结果完全一致。这种简单、廉价的操作很容易与手术室工作流程相兼容，无需头部固定，并且能提供独立于脑移位的实时图像。
