By Prof. Dr. med. Wolfgang Seeger (auth.)
ISBN-10: 3709130948
ISBN-13: 9783709130940
ISBN-10: 3709130964
ISBN-13: 9783709130964
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Additional resources for Microsurgery of the Brain: Anatomical and Technical Principles
Example text
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _--', FIG. 11 tv~ tv correct ® ® not correct FIG. 124 Fig. 12. General operative technique for tumors. Preparation of tumor of semiliquid consistency. Hardening of oversoft tumor surface by electrocoagulation is not possible A Small Dura and brain incision after precise preoperative localization of tumor 1 Coagulation of leptomeninges 2 Incision of coagulated zone B Evacuation of tumor with sucker possible. In the center of tumor a sucker of large caliber with high suction power is used (suction = suction power: diameter of lumen) C Loosening of marginal tumor areas using fine sucker with little suction power, supported by dissector (or forceps).
Continuation of preceding figure. Preparation of Arachnoidea during hemostasis A Wrong! If many arachnoidal fragments are present in tumor bed, extensive coagulation may lead to hemorrhages which are difficult to identify. A' Correct procedure instead of A: Cleansing tumor bed of not easily identifiable arachnoidal fragments by coagulation B Continuation of wrong procedure A 1 Further coagulation may be without effect if topical relationships in area of Arachnoidea are not clear 2 Additional application of Tabotamp © or Gelfoam © is dangerous B' Continuation of correct procedure A'.
Possibility of false localization by cr in upper parietal processes A Drawing of Cf-plane transecting tumor B CT corresponding to plane of A C Examples of various CT-planes a to e. The definition of the CT-base is possible by comparison of osseous and intracranial (e. g. ventricular) structures: a" to e" Corresponding basal planes, which allow definition of position of planes a to e D Drawing of CT-planes a to d and the corresponding tumor transectional planes a' to d' E CT of example e in figure C.