Mayfrank L, Reul J, Huffmann B, Bertalanffy H, Spetzger U, Gilsbach J M
Department of Neurosurgery, Medical Faculty of the Technical University (RWTH), Aachen, Germany.
Minim Invasive Neurosurg. 1996 Sep;39(3):74-7. doi: 10.1055/s-2008-1052221.
Six patients with a dural arteriovenous fistula (DAVF) of the floor of the anterior cranial fossa underwent microsurgical treatment. Two of them were operated using a conventional frontobasal approach, and four using an interhemispheric approach. The interhemispheric approach offers the advantages of sparing the frontal sinus, minimizing frontal lobe retraction, and providing a visual angle perpendicular to the floor of the anterior fossa and an excellent view of the fistula located on the cribriform plate at the level of the foramen caecum. Using the interhemispheric route, the malformation was occluded in all the cases by dividing the vascular connection between the dura of the cribriform plate and the intradural draining vein. There were no complications related to the surgical procedure. This route avoids some disadvantages of the more frequently reported frontobasal approach. It is therefore a recommendable alternative for the management of frontal DAVFs.
6例前颅窝底硬脑膜动静脉瘘（DAVF）患者接受了显微外科治疗。其中2例采用传统额底入路手术，4例采用半球间入路手术。半球间入路具有保留额窦、减少额叶牵拉、提供与前颅窝底垂直的视角以及能清晰观察位于盲孔水平筛板上的瘘口等优点。采用半球间入路，所有病例均通过切断筛板硬脑膜与硬脑膜内引流静脉之间的血管连接来闭塞畸形。未发生与手术相关的并发症。该入路避免了更常报道的额底入路的一些缺点。因此，它是治疗额叶DAVF的一种值得推荐的替代方法。
