Alhoobi Mohammed M M, Khan Adnan, Abu-Qadous Fatma Faris, Kockro Ralf, Hammadi Firas, Jarir Raed Abu, Belkhair Sirajeddin, Ayyad Ali
Department of Neurosurgery, Hamad Medical Corporation, Doha, Qatar.
Department of Neurosurgery, Hirslanden Klinik, Zurich, Switzerland.
Asian J Neurosurg. 2020 Aug 28;15(3):660-665. doi: 10.4103/ajns.AJNS_29_20. eCollection 2020 Jul-Sep.
Approaches to the hypothalamus and anterior third ventricle are variable. We present a technical note on access of the hypothalamus using the trans-lamina terminalis approach by supraorbital craniotomy in a patient who had a hypothalamic cavernoma and presented to us with recurrent hemorrhage.
The trans-lamina terminalis approach, including anatomical landmarks and surgical steps through a supra-orbital craniotomy, is described and a comparison with other surgical corridors is discussed.
The supraorbital trans lamina terminalis approach allowed an effective access to the hypothalamic lesions. This approach provided a safe and minimally invasive corridor for gross total resection of the lesion since trespass of viable brain tissue is avoided. One clinical case illustrates the feasibility of the approach allowing complete removal of a cavernoma without surgery related neurological of endocrinological deficits.
The supra-orbital craniotomy for trans-lamina terminalis approach is a valid surgical choice for hypothalamic lesions. The major strengths of this approach include minimal brain retraction and direct end-on view; however, the long and narrow surgical corridor requires some technical familiarization. The clinical outcomes are comparable to other surgical corridors.
进入下丘脑和第三脑室前部的方法多种多样。我们报告了1例下丘脑海绵状血管瘤并反复出血的患者，采用经眶上开颅经终板入路进入下丘脑的技术要点。
描述了经眶上开颅经终板入路，包括解剖标志和手术步骤，并与其他手术通道进行了比较。
经眶上经终板入路可有效进入下丘脑病变部位。该入路为病变的全切除提供了安全且微创的通道，避免了对有活力脑组织的侵犯。1例临床病例说明了该入路的可行性，可完整切除海绵状血管瘤，且无手术相关的神经或内分泌功能缺损。
经眶上开颅经终板入路是治疗下丘脑病变的有效手术选择。该入路的主要优点包括脑牵拉最小和直视效果好；然而，狭长的手术通道需要一定的技术熟练过程。临床结果与其他手术通道相当。
