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Safe and accurate sylvian dissection with the use of indocyanine green videoangiography.


ABSTRACT: Sylvian dissection is an essential microneurosurgical skill for neurosurgeons. The safe and accurate opening of the sylvian fissure is desirable for a good prognosis.The aim of this report is to demonstrate the use of indocyanine green (ICG) videoangiography to recognize the superficial sylvian vein (SSV) and thus enable a wide opening of the sylvian fissure, especially in patients with subarachnoid hemorrhage (SAH).The small tributary flowing into the SSV was distinguishable from a passing one, which deeply entered the insula. In addition, an entering point of a tributary to the SSV, which ran perpendicular to the insula, was occasionally determined. SSV, which was barely discernable in a reddish SAH involving the sylvian fissure, was clearly demarcated using ICG videoangiography. Two representative cases of sylvian dissection are herein presented.The performance of ICG videoangiography before sylvian dissection is a simple and useful method for identifying a vital approach route for safe and accurate sylvian dissection, and it reduces the risk of causing any accidental injury to the veins in the sylvian fissure.

SUBMITTER: Kubota H 

PROVIDER: S-EPMC4901820 | biostudies-other | 2016

REPOSITORIES: biostudies-other

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Safe and accurate sylvian dissection with the use of indocyanine green videoangiography.

Kubota Hisashi H   Sanada Yasuhiro Y   Nagatsuka Kazuhiro K   Yoshioka Hiromasa H   Iwakura Michihiro M   Kato Amami A  

Surgical neurology international 20160603 Suppl 14


<h4>Background</h4>Sylvian dissection is an essential microneurosurgical skill for neurosurgeons. The safe and accurate opening of the sylvian fissure is desirable for a good prognosis.<h4>Methods</h4>The aim of this report is to demonstrate the use of indocyanine green (ICG) videoangiography to recognize the superficial sylvian vein (SSV) and thus enable a wide opening of the sylvian fissure, especially in patients with subarachnoid hemorrhage (SAH).<h4>Results</h4>The small tributary flowing i  ...[more]

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