The Microsurgical Approaches to the Target Areas of the Brain
Preface Drawings and scripts were selected from those tion of the operative routes and their alternatives which were produced by the author in the last for well-defined anatomical target areas alone. This three years to help educate young neurosurgeons viewpoint becomes more and more important, be in Freiburg and in other clinics. cause today there is no anatomical structure of the This programm for education may be managed in 2 brain which cannot be approached with a minimal steps: risk for surviving the operation. But more and more - Learning techniques for performing of trepana the risk for neurologicalor psychological postopera tions from opening of the skin onto dura incision tive complications will rise if the anatomical and (step 1) neurophysiological knowledge is insufficient. These - Learning of techniques for routine operations viewpoints are most important in operations at the (e. g. , for extirpation of gliomas of cerebral lobes) cranial base and operations transcrossing midline (step 2) structures of the brain. An intensive anatomical - Learning of techniques for operative approach es training helps to understand MRI before opera in problematic areas of the cranial and cerebral tion. Often the modern MRI demonstrates more base and of the midline, especially for the often anatomical details than the unexperienced neurosur performed operations, e. g. for basal meningeo geon has understood.
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Locations on Skull Brain and Surface of the Head
Definition of Trepanations Dependent from Target Areas
Special Aspects of MRI
Special Planning Strategies and Microsurgical Operative Procedures
Frontal Target Areas with Aspects of Suprasellar Approaches
Pterional Target Areas Details
Clinical Sample of a Frontobasal Frontomedial Approach with Alternative Pterional Approach for the Same Target Area Olfactory Groove Meningeo...
Temporal Target Areas
Dorsal Midline Approaches
Intracerebellar Target Areas
Target Areas 4th Ventricle
Lateral Extracerebral Infratentorial Target Areas
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3rd ventricle 4th ventricle Abbreviations Anatomical sketch approach for Cisterna approach for target arachnoid layers arrows basal ganglia brain Bregma bridging veins bulging carotis int cerebelli cerebri post Chiasma chorioidea cinguli Cisterna ambiens Cisterna tecti close Commissura Cornu inf coronal corporis callosi cranial base Crus cerebri distance measurement dorsal direction Dorsal midline approaches dotted line dura Falx Fissura transversa foramen of Monro Fossa frontal frontobasal galenic vein gyri Gyrus parahippocampalis hollowing incision Infratentorial Insula Lamina terminalis landmarks lateral lesion Lobulus quadrangularis located loosening medial meningeomas Microsurgical topography Nucleus dentatus operative approach perforating arteries petrous bone Planning strategies Plexus chorioideus proaches pterional pterional approach Recessus resection route sagittal seen segment sellae Sinus skull slice structures Sulcus surface sylvian fissure Taenia fornicis target area temporal lobe temporobasal tentorial edge Tentorium Thalamus tion Tonsilla topogram Tractus opt transectional plane trepanation tumor Uncus Velum interpositum Velum medullare wall Yasargil