Stefanov I, Stefanov A, Westman J
Department of Human Anatomy, Biomedical Centre, Sweden.
Anat Embryol (Berl). 1996 Oct;194(4):319-26. doi: 10.1007/BF00198533.
A new method of direct endoscopy of the subarachnoid space and a major part of the ventricles of the human central nervous system is presented. The technique was developed on more than 100 human bodies with the help of a bronchoscope. Percutaneous entry into the subarachnoidal space is performed from the dorsal side between vertebrae L5 and S1. The endoscope can be moved along the spinal cord on both the dorsal and the ventral side. From the dorsal side of spinal cord the cerebello-medullary cistern can be reached. The fourth ventricle is entered through the median aperture and then the third ventricle through the cerebral aqueduct. From the ventral side of the spinal cord the posterior cranial fossa is reached and the large arteries and the cranial nerves can be inspected. The main conclusion of the present report is that the subarachnoid space seems to be large enough for a coaxial exploration with a 3-5 mm diameter fibroscope if the investigator possesses a good knowledge of the subarachnoid anatomy. The technique provides new approaches in research and possibilities of clinical investigations and therapy.
本文介绍了一种直接对人体中枢神经系统蛛网膜下腔及大部分脑室进行内镜检查的新方法。该技术是借助支气管镜在100多具人体上研发出来的。经皮从L5和S1椎体之间的背侧进入蛛网膜下腔。内窥镜可在脊髓的背侧和腹侧沿脊髓移动。从脊髓背侧可到达小脑延髓池。通过正中孔进入第四脑室，然后通过中脑导水管进入第三脑室。从脊髓腹侧可到达后颅窝，并可检查大动脉和颅神经。本报告的主要结论是，如果研究者对蛛网膜下腔解剖结构有充分了解，蛛网膜下腔似乎足够大，能够用直径3 - 5毫米的纤维镜进行同轴探查。该技术为研究提供了新途径，也为临床研究和治疗带来了新的可能性。
