側頭下アプローチによるクリッピング

Neck Clipping via Subtemporal Approach

Point

・側頭下アプローチ（subtemporal approach）には，前後方向に広い術野が得られることと，近位脳底動脈を確保しやすい利点がある．

・低位例に対しても，小脳テントを切開するtranstentorial subtemporal approachで対応可能である．

・欠点として側頭葉損傷のリスクがあり，この回避には，適切な体位，十分な髄液排出，架橋静脈の温存および間欠的な側頭葉牽引が重要である．

　The subtemporal approach offers the advantages of a wide surgical field in the anteroposterior direction and easy access to the proximal basilar artery. This approach can be adapted to treat low-positioned aneurysms using a tentorial incision, known as the subtemporal transtentorial approach. However, a disadvantage of the subtemporal approach is the risk of injury to the temporal lobe. To mitigate this risk, it is important to ensure proper positioning, adequate cerebrospinal fluid drainage, preservation of the bridging veins, and intermittent retraction of the temporal lobe.