侧脑室、三脑室神经内镜应用解剖

目的：了解神经内镜下脑室的解剖特点和重要解剖标志及比较不同脑室入路的特点。方法：10例成年国人尺头、10例脑积水患者。用内镜分别从侧脑室的额角、枕角、三角区和颞角进入，观察镜下所见和脑室内各组织的毗邻关系。结果：（1）进入脑室的穿刺点有四个：额角、枕角、三角区、颞角穿刺点；（2）经额角入路暴露范围最大，前至额角，后至枕角，下至三脑室及导水管；（3）从枕角入咱可借助脉络丛定位；（4）经三角区入路既可向前进入额角，双可向后下方进入颞角，脉络从和室间孔是重要的标志。结论：（1）侧脑室形态固定，解剖标志明确，应用神经内窥镜可使脑室内的部分病变在直视下切除，并且创伤较小；（2）大多数病变采用额角、枕角入路，三角区和颞角入路可用为补充。

Endoscopic anatomy of the lateral ventricles and third ventricles

Objective To study the anatomic characteristics and important marks of ventricles under the neuroendoscope and compare the advantages of different approaches to ventricles. Methods 10 adult cadavers head and 10 patients of hydrocephalus were operated to observe the structure and important marks of ventricles under neuroendoscope using different approach. Results (1) There were four approaches to ventricles: frontal, occipital, triangle area and temporal point. (2) It could get the clearest exposure by using frontal angle approach. (3) The chroid plexus and foramen of monro were important marks in most approachs. Conclusions (1) The lesion in ventricles can be managed directly under endoscope with left little damage. (2) Frontal horn approach and occipital approach are in using very often, and triangle area and temporal approach are complementary to them.