经小脑上幕下入路治疗左侧海马旁海绵状血管畸形
Supracerebellar transtentorial approach for left parahippocampal cavernous malformation.
作者信息
López López Laura Beatriz, Moles Herbera Jesús Adrián, Vázquez Sufuentes Silvia, Fustero de Miguel David, Avedillo Ruidíaz Amanda, Orduna Martínez Javier, Pellejero Juan Casado
机构信息
Department of Neurosurgery, Miguel Servet University Hospital, Zaragoza, Spain.
出版信息
Surg Neurol Int. 2021 May 10;12:216. doi: 10.25259/SNI_166_2021. eCollection 2021.
BACKGROUND
Lesions in the temporomesial region can be reached by various approaches: subtemporal, transsylvian, transcortical, interhemispheric parieto-occipital, or supracerebellar transtentorial (SCTT). The choice varies according to the characteristics of the lesion and neighboring structures.
CASE DESCRIPTION
In this clinical case, it is presented a 56-year-old man with long-term evolution of drug-resistant epilepsy secondary to a cavernoma in the left parahippocampal gyrus. After assessing the lesion, it was decided a SCTT approach for its resection in a semi-sitting position, to avoid language disorders or visual damage. The surgery was uneventful and the patient did not present epileptic seizures during 6-month follow-up.
CONCLUSION
Performing a SCTT is safe and feasible option for resection of lesions located in the basal temporomesial region without causing damage to neighboring structures, especially those located in the middle and posterior two-thirds of temporal region.
背景
颞叶内侧区域的病变可通过多种入路到达：颞下、经侧裂、经皮质、半球间顶枕或小脑上幕下（SCTT）。选择会根据病变及邻近结构的特征而有所不同。
病例描述
在本临床病例中，介绍了一名56岁男性，因左侧海马旁回海绵状血管瘤继发耐药性癫痫，病程较长。在评估病变后，决定采用SCTT入路，在半坐位下切除病变，以避免语言障碍或视觉损伤。手术顺利，患者在6个月的随访期间未出现癫痫发作。
结论
对于位于颞叶内侧基底区域的病变，采用SCTT进行切除是一种安全可行的选择，不会对邻近结构造成损伤，尤其是位于颞叶中后三分之二区域的结构。
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