Reappraising the neurosurgical significance of the pterion location, morphology, and its relationship to optic canal and sphenoid ridge and neurosurgical implications / 대한해부학회지

Pterional, Trans-Sylvian Approach for Aneurysm Surgery / 대한뇌혈관학회지

Pterional, trans-sylvian approach is a basic and most popular neurosurgical procedure used in surgical treatment of various vascular, tumor and other lesions located in and around the sellar and parasellar region. It has several benefits such as a shorter working distance, anatomical familiarity, lesser need for brain retraction with wide sylvian dissection, ability of extension with some modification. All anterior circulation aneurysm except pericallosal origin aneurysm and some aneurysm of posterior circulation can be approached with pterional, trans-sylvian method. The authors discribe the procedure of pterional trans-sylvian approach.

Superior Temporal Gyrus Approach to Middle Cerebral Artery Aneurysms

Authors experienced 36 cases of middle cerebral artery aneurysms in 35 patients. Among 36 cases, M1 aneurysms were 4 cases, M1 bi-or trifurcation aneurysms 30 cases, and distal aneurysms 2 cases. The majority of M1 bi-or trifurcation aneurysms were operated upon by the superior temporal gyrus approach. Trans-sylvian approach was used only in M1 aneurysms, in cases of short M1, in associated anterior circulation aneurysms, and in second operation to the unruptured middle cerebral artery aneurysms. Our results were encouraging. Mortality was 5.6%, and morbidity was also 5.6%.

Surgical Management of the Hypertensive Intracerebral Hemorrhage

Surgical decision for the hypertensive intracerebral hemorrhage remains as a difficult problem in neurosurgery. In this review the author discussed such a problem and analyzed 95 consecutive cases of microsurgically treated hypertensive intracerebral hemorrhage in the supratentorial region. The surgical morbidity and mortality were decreased markedly, 18% and 16% each, compare to the previous series. Establishment of the meticulous surgical procedures, surgical planning assisted by the CT scan, monitoring and management of the intracranial pressure, prevention of the cardiopulmonary complication, and conception of the early surgical evacuation for the lobar, cerebellar and superficial gangliobasal hematoma, devoted to improvement of the surgical outcome.

Surgical Management of the Hypertensive Intracerebral Hemorrhage

Surgical decision for the hypertensive intracerebral hemorrhage remains as a difficult problem in neurosurgery. In this review the author discussed such a problem and analyzed 95 consecutive cases of microsurgically treated hypertensive intracerebral hemorrhage in the supratentorial region. The surgical morbidity and mortality were decreased markedly, 18% and 16% each, compare to the previous series. Establishment of the meticulous surgical procedures, surgical planning assisted by the CT scan, monitoring and management of the intracranial pressure, prevention of the cardiopulmonary complication, and conception of the early surgical evacuation for the lobar, cerebellar and superficial gangliobasal hematoma, devoted to improvement of the surgical outcome.