松果体区肿瘤切除术中对Galen静脉及其属支的处理

目的　为了有效地显露松果体区 ,探讨切断阻挡手术入路的大脑大静脉 (Galen静脉 )的属支的可行性。方法　总结过去 10年来本院 2 6例松果体区肿瘤病例 ,经Poppen入路或经Krause入路切除肿瘤时对Galen静脉及其分支的处理情况。结果　 15例经Krause入路的患者小脑表面的桥静脉被离断 ,有 8例切除了一侧小脑中央前静脉 ,另有 2例双侧该静脉被切断 ;11例Poppen入路的患者中 ,有 9例离断一侧的枕内静脉 ;有 12例四叠体的静脉一支或两支被切断。结论　在处理阻挡术野的静脉时 ,应观察该血管走行、位置、直径、吻合支以及引流情况 ,特别要注意是否存在变异 ,不宜贸然将其灼断。

Consideration of vein of galen and its brunches in removal of pineal tumors

Objective To investigate the management of branches of Galen vein which interfere with operative approach in the exposure of pineal region. Methods The data of 26 patients suffered with pineal tumor and given surgically treatment via Poppen or Krause approaches in the past 10 years were analyied focusing on the management of Galen vein and its brunches. Results In 15 patients via Krause approach, all of cerebellar bridge veins were cut off, anterior central cerebellar vein was severd unila terally in 8 patients and bilaterally in other 2 patients. In 11 patients throught Poppen approach, internal occipital vein was cut off in 9 patients; one or two branches of collicular veins were cut off in 12 patients. Conclusions When we deal with veins which interfere in the operative pathway, a lot of details about the veins must be considered, eg, the course, location, diameter, anastomosis, drainage, and especially the possible exsistence of any congenital abnormality.