脳卒中の外科
Online ISSN : 1880-4683
Print ISSN : 0914-5508
ISSN-L : 0914-5508
中大脳動脈瘤 (M1末梢部) の手術法
田中 輝彦藤本 俊一斎藤 和子中村 公明
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1991 年 19 巻 1 号 p. 148-151

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It seems that the ordinary approach is best in the direct treatment of middle cerebral artery aneurysms. But, sometimes, it is very dangerous with some special types of aneurysms which project rostrally or laterally and/or are attached to the dura mater. The procedure may cause premature rupture, due to retraction of the frontal lobe and the middle cerebral artery itself.
The distal approach is best suited for such types of aneurysms.
But then, we prefer to use the superior approach, by which we are able to treat the aneurysmal neck easily with safety without any brain damage, to the usual type of aneurysm.
The selection of the approach is based on a lateral view of the CAG. If the aneurysmal shadow is obviously rostral from M1 and origin of M2 branches, the distal approach should be selected.
The only indication for the ordinary approach is on aneurysm of early bifurcation of the middle cerebral artery.

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© 一般社団法人 日本脳卒中の外科学会
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