The contralateral transcallosal approach: Experience with 32 patients
The contralateral transcallosal approach: Experience with 32 patients
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DOI：
10.1097/00006123-199610000-00016
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发表时间：
1996-10-01
期刊：
影响因子：
4.8
通讯作者：
Spetzler, RF
中科院分区：
文献类型：
--
作者：
Lawton, MT;Golfinos, JG;Spetzler, RF
目的：证明对侧经胼胝体入路切除位于侧脑室内或侧脑室附近病变的有效性。方法：对标准同侧经胼胝体入路技术的修改包括将头部中线水平定位，将病变侧向上放置，并在对侧进行开颅和半球间解剖。这种方法避免了经皮层切口，允许重力保持半球间裂打开，并增加病变的侧向暴露。该入路应用于32例多种病变患者，其中海绵状血管瘤6例、动静脉畸形7例、各类肿瘤19例。除三个病变外，所有病变均位于左侧。结果：所有六个海绵状血管瘤、所有四个良性肿瘤以及七个动静脉畸形中的四个均被完全切除。恶性肿瘤被次全切除，三处动静脉畸形需要立体定向放射外科治疗残留的深部病灶。无手术死亡。两名患者出现神经功能恶化。结论：对侧经胼胝体入路可安全、成功地治疗多种病变。
OBJECTIVE: To demonstrate the usefulness of the contralateral transcallosal approach for resecting lesions located laterally in or adjacent to the lateral ventricle.METHODS: Modifications to the standard ipsilateral transcallosal technique include positioning the head with the midline oriented horizontally, placing the side with the lesion up, and performing the craniotomy and interhemispheric dissection on the contralateral side. This approach avoids a transcortical incision, allows gravity to hold open the interhemispheric fissure, and increases the lateral exposure of the lesion. This approach was used in 32 patients with a variety of lesions, including 6 cavernous malformations, 7 arteriovenous malformations, and 19 tumors of various types. All but three lesions were located on the left side.RESULTS: All six cavernous malformations, all four benign tumors, and four of the seven arteriovenous malformations were resected completely. Malignant tumors were resected subtotally, and three arteriovenous malformations required stereotactic radiosurgery to treat residual deep nidus. There was no surgical mortality. Two patients experienced neurological deterioration.CONCLUSION: The contralateral transcallosal approach can be used to treat a variety of lesions safely and successfully.