Neurological Surgery 脳神経外科50巻2号

2022年03月発行

特集 水頭症—脳脊髄液動態への理解と治療に迫る Ⅲ水頭症の治療

内視鏡的第三脳室開窓術の理論と実際

著者： 西山健一¹

所属機関： ¹JA新潟厚生連新潟医療センター脳神経外科

ページ範囲：P.366 - P.375

Point
・内視鏡的第三脳室開窓術（ETV）は髄液拍動のエネルギーをくも膜下腔に伝え，脳室壁を介して脳実質に与えていた拍動の負荷を軽減させる．
・稀ではあるが脳底動脈を損傷した際は，脳圧制御下に洗浄して止血を待つのが肝要である．
・ETVは閉塞し得るので術後フォローが必要である．

参考文献

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9）西山健一：（3）乳児期の水頭症治療（脊髄髄膜瘤合併）-シャント手術 vs. ETV. No Shinkei Geka 47：27-37, 2019

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16）Froelich SC, et al：Microsurgical and endoscopic anatomy of Liliequist's membrane：a complex and variable structure of the basal cisterns. Neurosurgery 63（1 Suppl 1）：ONS1-ONS8；discussion ONS8-ONS9, 2008

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21）西山健一，藤井幸彦：小児水頭症に対する外科治療の最前線．脳外誌 24：452-458, 2015

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