幕上脑室的神经内镜应用解剖学研究

The endoscopic anatomy study of the supratentorial ventricles

目的 研究脑室的神经内镜应用解剖学特点 ,探讨其临床应用价值。方法 在 16例尸颅标本、2 0例脑积水患者手术中用神经内镜观察侧脑室、三脑室的解剖结构。其中在尸颅标本采用经侧脑室额角、枕角和三脑室后部入路观察脑室 ;在脑积水患者中均采用经额角入路。结果 经额角入路观察侧脑室体部、枕角 ,三脑室底部、后部 ;经枕角观察到从颞角到额角的脉络丛。在侧脑室内观察的重要“路标”是室间孔处的Y形结构。结论 经额角入路观察范围最大 ,是脑室内神经内镜手术的最常用入路 ,经此入路可以同时完成多种手术。经枕角观察到的脉络丛最多 。

Objective To study the endoscopic anatomy of supratentorial ventricles and its clinical value.Methods The anatomic characters were observed in 15 cadavers and 20 hydrocephalus patients. In cadaver heads,the endoscope was guided into later ventricles via the front horn, occipital horn and posterior part of third ventricle.Results The body and occipital horn of the later ventricle could be observed via front horn approach.The posterior part and floor of third ventricle could be found via this approach,too.The choroids in the later ventricle could be found totally via occipital horn approach.The important“road mark”in the ventricle was the “Y” sharp structure at the Monroe hole.Conclusion The view field is the largest when someone observes ventricles via the front horn approach.The front horn approach is the best way of the treatment for lesions in the ventricles.The most part of choroid in the later ventricle can be found and coagulated.