CAJ | 학술논문

目的研究幕上内层蛛网膜形态、分类、分布,总结幕上内层蛛网膜的临床意义.方法 6例12侧成人头颅标本,在显微镜下探查硬膜下腔隙系带、蛛网膜下腔(各脑池)内层蛛网膜形态、分类及分布.同时查阅近期内镜下眉弓锁孔开颅手术录像3例、内镜下翼点锁孔开颅手术录像2例,描述并记录硬膜下腔隙、蛛网膜下腔(各脑池)内层蛛网膜形态、分类及分布.结合科室既往手术录像,总结内层蛛网膜临床意义.结果除了蛛网膜下腔外,硬膜下腔隙也存在类似蛛网膜的系带分布,以桥静脉、颅神经进出蛛网膜部位多见.幕上内层蛛网膜分为固有内层蛛网膜和附着内层蛛网膜,其形态有丝状、索状、带状、膜状.内层蛛网膜可为单独一种形态或者由多种形态混合而成.硬膜下间隙的系带以及各类型内层蛛网膜在肿瘤暴露、手术分离、动脉瘤夹闭以及脑积水治疗中有重要的意义.结论对颅内膜性结构的认识,建立膜性理念,对神经外科显微手术有重要的意义.
목적 연구막상내층주망막형태、분류、분포,총결막상내층주망막적림상의의.방법 6례12측성인두로표본,재현미경하탐사경막하강극계대、주망막하강(각뇌지)내층주망막형태、분류급분포.동시사열근기내경하미궁쇄공개로수술록상3례、내경하익점쇄공개로수술록상2례,묘술병기록경막하강극、주망막하강(각뇌지)내층주망막형태、분류급분포.결합과실기왕수술록상,총결내층주망막림상의의.결과 제료주망막하강외,경막하강극야존재유사주망막적계대분포,이교정맥、로신경진출주망막부위다견.막상내층주망막분위고유내층주망막화부착내층주망막,기형태유사상、색상、대상、막상.내층주망막가위단독일충형태혹자유다충형태혼합이성.경막하간극적계대이급각류형내층주망막재종류폭로、수술분리、동맥류협폐이급뇌적수치료중유중요적의의.결론 대로내막성결구적인식,건립막성이념,대신경외과현미수술유중요적의의.
Objective To study the morphology,classification,distribution and clinical significance of supratentorial inner arachnoid.Methods 6 cases (12 sides) of adult skull specimen was studied under the microscope.The morphology,classification,distribution of membrane structure in subdural space and subarachnoid space was carefully observed.3 videos of endoscopic eyebrow keyhole craniotomy and 2 videos of endoscopic pterion keyhole craniotomy were studied and the morphology,classification,distribution of membrane structure was confirmed.The significance of membrane structure was summarized according to the previous experience of our department.Results Besides subarachnoid space,the similar membranous structure can been seen in subdural space,which was more common beside the bridging veins and cranial nerve.Supratemorial inner arachnoid can be classified into inherent inner arachnoid (IIA) and adherent inner arachnoid (AIA).The morphology of supratentorial inner arachnoid include silk-like,cord-like,band-like and membranous-like.The morphology of supratentorial inner arachnoid can be single or combined type of the four mentioned above.Membranous structure plays a important role in tumor exposure,surgical dissection,aneurysm separation and hydrocephalus treatment.Conclusion The knowledge of intracranial membranous structure and the establishment of membranous concept have great significance in modem neurosurgery.