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Neurosurgery. 1977 Jul-Aug;1(1):36-40. doi: 10.1227/00006123-197707000-00008.
Nine pineal area lesions were operated upon by the infratentorial-supracerebellar approach. There was one operative death and one death due to disseminated germinoma recurrence 2 1/2 years postoperatively. The remaining seven patients have shown no sign of recurrence and are neurologically normal. The surgical method that has evolved through these nine cases is discussed. The infratentorial-supracebebellar exposure is an excellent one for lesions in the region of the pineal gland, posterior 3rd ventricle, and superior cerebellar vermis. Access is less hampered by the major tributaries of the vein of Galen than with the supratentorial operations. This approach is also a useful extension of the standard posterior fossa exploration when dealing with primarily subtentorial lesions that involve the dorsal midbrain or herniate upward.
采用幕下小脑上入路对9例松果体区病变进行了手术。有1例手术死亡，1例术后2年半因播散性生殖细胞瘤复发死亡。其余7例患者无复发迹象，神经功能正常。讨论了通过这9例病例发展而来的手术方法。幕下小脑上入路对于松果体区、第三脑室后部和小脑上蚓部区域的病变是一种很好的入路。与幕上手术相比，大脑大静脉的主要分支对该入路的阻碍较小。当处理主要位于幕下且累及中脑背侧或向上疝出的病变时，该入路也是标准后颅窝探查的有益扩展。
