侧脑室经脉络裂手术入路显微解剖学研究

目的：为神经外科医师如何利用脑室的自然裂隙到达第三脑室、基底池等脑组织深部结构又几乎不损伤正常脑组织提供理论基础。方法：10例国人成人头颅湿标本,在放大10倍的显微镜下对侧脑室脉络裂体部、三角部、颞部依照手术入路逐层进行解剖,观察。结果：脉络裂介于丘脑与穹隆之间呈倒“C”形。经脉络裂体部可到达第三脑室顶部;经脉络裂三角部可到达四叠体池;经脉络裂颞部可到达环池。本研究对经脉络裂到达上述部位的手术入路进行了显微解剖和观察。结论：经脉络裂入路处理第三脑室、颞叶内侧、环池的病变具有手术损伤小、术野暴露好等优点。

Microsurgical Anatomy of Transchoroidal Approach

Objective: To present the microsurgical anatomy to neurosurgeons, who might be interested in, of how properly to reach the deep cerebral structure of the third ventricle and basal cistern through ventricular cleft without any injury to normal brain tissues and vessels. Methods: Ten adult cadaveric wet cranio-cerebral specimens were carefully examined under microscope with 10-fold magnification. According to the transchorodial approach, the layer structure of the body, atrial part and temporal part of choroidal fissure were succesively explored. Results: Choroidal fissure is located between the thalamus and fornix with the appearance of reversal shape of "C". The roof of the third ventricle, quadrigemina and ambient could be reached by transchoroidal body, atrial part and temporal part approach respectively. Microsurgical anatomy was performed on the approaches mentioned above. Conclusion: Manipulating the lesions in third ventricle, medial temporal lobe and ambient by the transchoroidal approach is of advantages of less injury and wider exposure, suggesting therefore that the transchoroidal approach be extensively and reasonably adopted in clinical neurosurgery.