Hanalioglu Sahin, Sahin Omer Selcuk, Turkoglu Mehmet Erhan
Department of Neurosurgery, Health Sciences University, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
Neurosurg Focus Video. 2019 Jul 1;1(1):V23. doi: 10.3171/2019.7.FocusVid.19149. eCollection 2019 Jul.
This video demonstrates the resection of an anterolateral mesencephalic cavernous malformation (CM) through a transsylvian/transuncal approach. A 10-year-old girl presented with progressive headache and left-sided spastic hemiparesis. Neuroimaging revealed a 20-mm CM located in the right anterolateral midbrain/cerebral peduncle. After orbitozygomatic craniotomy and wide sylvian fissure opening, the oculomotor nerve was dissected and separated from the temporal lobe. Partial resection of the uncus allowed access to the CM through the oculomotor-tentorial triangle. The CM was excised in a piecemeal fashion. Postoperative imaging confirmed the gross-total resection. The patient had no additional neurological deficits postoperatively. Her left hemiparesis almost completely resolved at the 12-month follow-up. The video can be found here: https://youtu.be/Jb_EaWbn5LU.
本视频展示了通过经侧裂/经钩回入路切除中脑前外侧海绵状畸形（CM）的过程。一名10岁女孩出现进行性头痛和左侧痉挛性偏瘫。神经影像学检查发现右侧中脑前外侧/大脑脚有一个20毫米的CM。在进行眶颧开颅和广泛打开侧裂后，解剖动眼神经并将其与颞叶分离。部分切除钩回后，可通过动眼神经-小脑幕三角进入CM。CM被分块切除。术后影像学检查证实为全切。患者术后无额外神经功能缺损。在12个月的随访中，她的左侧偏瘫几乎完全缓解。视频可在此处查看：https://youtu.be/Jb_EaWbn5LU。
