中大脳動脈瘤の手術

Surgical Treatment of Middle Cerebral Artery Aneurysms

I．はじめに

　中大脳動脈瘤は，その大部分がM₁-M₂分岐部に発生し，それはSylvius裂の深部に位置する．著者らは長年にわたり，この部の動脈瘤の安全確実な手術方法の開発を目ざし，種々の検討を重ね，開頭法も試行錯誤し，いろいろと工夫してきた_5,11）．本報では，1981年6月までの約20年周に，頭蓋内直接手術を施行した413例の中大脳動脈瘤症例の直接手術の経験から，現在われわれが行っている手術方法について述べる．

A review of 413 cases of middle cerebral arteryaneurysms out of the means of 1621 cases which wereoperated upon by one of the authors (J. Suzuki), ismade with regard to their surgical management.

At operation, the patient is placed in the supineposition with the head fixed neutral and chin slightlyup. Small craniotomy is performed by means of asmall semi-circular skin incision just hebind the hairline. After exposure of the internal carotid artery,the arachnoid overlying the Sylvian fissure is cutdistally in order to expose the middle cerebral artery.