Surgical accesses to lesions of the posterolateral pontomesencephalic junction（PMJ）region and the posterolateral tentorial gap remain a challenge in the field of neurosurgery.Since the first report of application of...Surgical accesses to lesions of the posterolateral pontomesencephalic junction（PMJ）region and the posterolateral tentorial gap remain a challenge in the field of neurosurgery.Since the first report of application of the extreme lateral supracerebellar infratentorial（ELSI）approach in resecting the PMJ lesions in 2000,a few articles concerning the ELSI approach have been published.The present review mainly provided an intimate introduction of the ELSI approach,and evalu- ated it in facets of patient position,skin incision,craniectomy,draining veins,retraction against the cerebellum,exposure limits,patient healing,as well as advantages and limitations compared with other approaches.The ELSI approach is proposed to be a very young and promising approach to access the lesions of posterolateral PMJ region and the posterolateral tentorial gap.Besides,it has several advantages such as having a shorter surgical pathway,causing less surgical complications,laborsaving,etc.Still,more studies are needed to improve this approach.展开更多
Objective:: To explore the role of tentorium cerebelli hiatus incision in treating severe and most severe brain injuries complicated by tentorial herniation. Methods: From July 1994 to July 1999 tentorium cerebelli hi...Objective:: To explore the role of tentorium cerebelli hiatus incision in treating severe and most severe brain injuries complicated by tentorial herniation. Methods: From July 1994 to July 1999 tentorium cerebelli hiatus incision was done based on intracranial hematoma evacuation and bone flap craniectomy decompression in 70 cases of severe and most severe brain injuries complicated by tentorial herniation. Results: Of the 70 cases, GCS 3-5 was in 23 and GCS 6-8 in 47; satisfactory recovery in 39 cases ( 55.7 %), moderate disability in 12 ( 17.1 %), severe deficit in 6 ( 8.6 %), vegetative survival in 4 ( 5.7 %) and 8 ( 11.4 %) died. Conclusions: Tentoriun cerebelli incision is helpful in alleviating secondary brain stem injury from tentorial herniation and in reducing the disability and death rate of the patients.展开更多
基金supported by the grants from Natural Science Foundation of Shandong Province(No.Z2008C12,Y2006C13)
文摘Surgical accesses to lesions of the posterolateral pontomesencephalic junction（PMJ）region and the posterolateral tentorial gap remain a challenge in the field of neurosurgery.Since the first report of application of the extreme lateral supracerebellar infratentorial（ELSI）approach in resecting the PMJ lesions in 2000,a few articles concerning the ELSI approach have been published.The present review mainly provided an intimate introduction of the ELSI approach,and evalu- ated it in facets of patient position,skin incision,craniectomy,draining veins,retraction against the cerebellum,exposure limits,patient healing,as well as advantages and limitations compared with other approaches.The ELSI approach is proposed to be a very young and promising approach to access the lesions of posterolateral PMJ region and the posterolateral tentorial gap.Besides,it has several advantages such as having a shorter surgical pathway,causing less surgical complications,laborsaving,etc.Still,more studies are needed to improve this approach.
文摘Objective:: To explore the role of tentorium cerebelli hiatus incision in treating severe and most severe brain injuries complicated by tentorial herniation. Methods: From July 1994 to July 1999 tentorium cerebelli hiatus incision was done based on intracranial hematoma evacuation and bone flap craniectomy decompression in 70 cases of severe and most severe brain injuries complicated by tentorial herniation. Results: Of the 70 cases, GCS 3-5 was in 23 and GCS 6-8 in 47; satisfactory recovery in 39 cases ( 55.7 %), moderate disability in 12 ( 17.1 %), severe deficit in 6 ( 8.6 %), vegetative survival in 4 ( 5.7 %) and 8 ( 11.4 %) died. Conclusions: Tentoriun cerebelli incision is helpful in alleviating secondary brain stem injury from tentorial herniation and in reducing the disability and death rate of the patients.
