新颖的半球硬脑膜间内翻技术用于间接副法新脑血管重建术:病例报告。

Neurosurgery practice Pub Date : 2024-04-05 eCollection Date: 2024-06-01 DOI:10.1227/neuprac.0000000000000085
Nadia A Atai, Vincent N Nguyen, Alexandra Kammen, Sarah Sternbach, Robert C Rennert, Jonathan J Russin
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引用次数: 0

摘要

背景和重要性:多种血运重建策略已被用于治疗脑血流恶化。血流恢复可以通过直接或间接的程序来实现。增加血流量的间接重建手术涉及脑肌病、脑硬动脉合并病或脑硬血管合并病,并已有效用于缺血性烟雾病。然而,首选手术必须在个案基础上进行评估,并且在其他脑动脉疾病中仍然存在争议。在这里,我们报道“半球间硬脑膜倒置(IDI)”作为间接镰旁皮层血运重建术的新技术。临床表现:一名54岁白人男性,儿童霍奇金淋巴瘤继发颈部放射史复杂,表现为右侧近初级视觉皮层的内medial ocital lobe局灶性灌注缺损。取一个大的c形硬脑膜瓣,带旁基底,在半球间剥离后,与缺血的镰旁皮质组织(IDI)接触。结论:IDI成功地用于间接血运重建局灶性右侧旁位枕叶缺陷的54岁男性,该患者因儿童放疗和多次搭桥手术而患有复杂的脑闭塞疾病。IDI是一种简单的定向间接镰旁皮层血运重建术,以促进血液供应的增加,并促使新血管从原有的硬膜动脉中生长。它可以作为一个独立的技术或结合其他血运重建策略,根据需要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Novel Interhemispheric Dural Inversion Technique for Indirect Parafalcine Cerebral Revascularization: Case Report.

Background and importance: Variety of revascularization strategies have been deployed to treat the deterioration of cerebral blood flow. Blood flow restoration can be achieved by direct or indirect procedures. The indirect reconstructive procedure to augment blood flow involves encephalomyosynangiosis, encephaloduroarteriosynangiosis, or encephalodurosynangiosis, and has been used effectively in ischemic Moyamoya disease. However, the preferred procedure must be evaluated on a case-by-case basis and remains controversial in other cerebral arterial diseases. Here, we report the "interhemispheric dural inversion (IDI)" as a novel technique for indirect parafalcine cortical revascularization.

Clinical presentation: A 54-year-old white man with a complex history of neck radiation secondary to childhood Hodgkin's lymphoma presented with focal perfusion deficit in the right mesial occipital lobe near the primary visual cortex. A large c-shaped dural flap with a paramedian base is harvested and, after an interhemispheric dissection, placed in contact with the ischemic parafalcine cortical tissue (IDI).

Conclusion: The IDI was used successfully for indirect revascularization of a focal right paramedian occipital lobe deficit in a 54-year-old man with complex cerebro-occlusive disease from childhood radiation and multiple previous bypass surgeries. The IDI is a simple approach for targeted indirect parafalcine cortical revascularization to facilitate an increased blood supply and prompt new vessels to sprout from preexisting dural arteries. It can be used as a standalone technique or combined with other revascularization strategies, as warranted.

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