Solomon R A, Stein B M
Neurosurgery. 1986 Jun;18(6):708-15. doi: 10.1227/00006123-198606000-00005.
In a series of 200 intracranial arteriovenous malformations (AVMs) treated surgically, 33 malformations were situated very close to the tentorial incisura. All but one of these AVMs were totally removed. Four operative approaches were utilized in this group of patients: an interhemispheric approach for lesions of the medial hemispheres, splenium of the corpus callosum, and posterior 3rd ventricle; a subtemporal approach to the inferior and medial temporal lobe; a supracerebellar-infratentorial approach to anterodorsal cerebellum and quadrigeminal regions; and a subtemporal transtentorial exposure to the dorsolateral mesencephalon. There were no surgical deaths. Three patients had unsatisfactory outcomes. Our experience with this series indicates that deep cerebral AVMs in the region of the tentorial incisura may be safely removed if there is proper selection of operative approach and attention to surgical technique.
在一系列200例接受手术治疗的颅内动静脉畸形（AVM）中，有33个畸形位于小脑幕切迹附近。除其中1个AVM外，其余均被完全切除。该组患者采用了四种手术入路：经纵裂入路用于治疗大脑半球内侧、胼胝体压部及第三脑室后部的病变；颞下入路用于治疗颞叶下部和内侧；经小脑上-幕下入路用于治疗小脑前背侧和四叠体区域；颞下经小脑幕入路用于暴露中脑背外侧。无手术死亡病例。3例患者预后不满意。我们对该系列病例的经验表明，如果能正确选择手术入路并注意手术技巧，小脑幕切迹区域的深部脑AVM可以安全切除。
