Microsurgical Anatomy and Surgical Approach to the Trigone of the Lateral Ventricle(<SPECIAL ISSUE>Tumors of the Lateral Ventricle: Diagnosis and Management)

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  • 側脳室三角部の微小外科解剖と手術アプローチ(<特集>側脳室腫瘍の診断と治療)

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We describe the various surgical approaches to the trigone of the lateral ventricle. There are four main approaches to those areas 1) a transcortical approach through the cerebral convexity, 2) a transcortical approach through the inferior surface of the temporal lobe, 3) an interhemispheric transcallosal or transcortical approach, and 4) a distal transsylvian approach. Many important structures such as the speech center area in the dominant cerebral hemisphere, visual pathways and high cognitive functions in the parieto-temporo-occipital lobes should be preserved during the surgical procedure. The high parietal lobe approach should be recommended in the dominant cerebral hemisphere. The stepwise procedures are demonstrated with a case of meningioma in the trigone of the left lateral ventricle. Knowledge of the microsurgical anatomy and an intraoperative neuronavigation system are helpful for safer and less invasive microsurgery.

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