前頭窩腔內 占有性疾患의 腦血管 撮影像의 特術

Abstract

[한글]

Angiographic Patterns of Space Occupying Lesions in the Anterior Cranial Fossa

Yung-chul Ok, M.D.

Department of Neurosurgery, The Graduate School, Yonsei University

Director: Prof. Hun Jae Lee, M.D.

Although reports have been assessed to located lesions in the frontal lobe or

frontal fossa, the exact localization of the lesion is invariably difficult in

neurological examinations due to content of the broad silent area in the lobe.

However angiographic patterns are most significant in the diagnosis of this area.

for the past 2 years, from May in 1968 to September in 1970, we have analyzed

angiographic patterns of space occupying lesions in the frontal lobe and fossa in a

total of subsequent 85 cases.

It is suggested that these lesions be classified into four groups according to

their characteristic patterns and, for accurate localization and practical

feasibility, their surgical approach.

The characteristic angiographic patterns of each group are summarized as follows:

Frontal-pole

A-P view

1. round shift of A.C.A.

2. flattening of carotid fork.

3. elongation of A1.

4. no checkrein effect.

5. sylvian point & M.C.A.---normal.

Lateral view

1. posterior displacement of A.C.A.

2. vertical stretching of A2-A3.

3. stretching of frontopolar artery.

4. downward displacement of M2.

5. depression of candelabra artery.

6. closing of carotid siphon.

7. ophthalmic artery---normal.

Fronto-central

A-P view

1. round shift of A.C.A.---mild.

2. checkrein effect.

3. depression of M1.

4. flattening or mushroom appearence of carotid fork.

5. sylvian point---normal.

Lateral view

1. rectangular erection of C1-M1.

2. fight angle of C1-C2.

3. elevation of M2-M3.

4. P.C.A. & ant. choroidal artery---better filling and posterior-basal

bulging.

Fronto-lateral

A-P view

1. roundd shift of A.C.A.

2. infrequent checkrein effect.

3. flattening of carotid fork.

4. vertical stretching of C1.

5. sylvian point---normal.

Lateral view

1. mild stretching of A2-A3.

2. continuous line of C2-M2.

3. depression of M2.

4. Stretching of candelabra artery.

Fronto-basal

A. Subfrontal

A-P view

1. round or angular ahift of A.C.A.

2. flattening of carotid bifurcation.

3. no checkrein effect.

4. sylvian point---normal.

Lateral view

1. bowing and downward convexity of A.C.A.

2. closing of sylvian artery group.

3. depression of sylvian artery group.

4. enlargement of ophthalmic artery.

B. Inferior frontal

A-P view

1. same as subfrontal lesion midline shift of A.C.A.---mild.

Lateral view

1. bowing of A.C.A.

2. relative preservation of A.C.A. branches.

3. enlarged ophthalmic artery---mild.

4. depression or elevation of M2.

[영문]

Although reports have been assessed to located lesions in the frontal lobe or frontal fossa, the exact localization of the lesion is invariably difficult in neurological examinations due to content of the broad silent area in the lobe.

However angiographic patterns are most significant in the diagnosis of this area.

for the past 2 years, from May in 1968 to September in 1970, we have analyzed angiographic patterns of space occupying lesions in the frontal lobe and fossa in a total of subsequent 85 cases.

It is suggested that these lesions be classified into four groups according to their characteristic patterns and, for accurate localization and practical feasibility, their surgical approach.

The characteristic angiographic patterns of each group are summarized as follows:

Frontal-pole

A-P view

1. round shift of A.C.A.

2. flattening of carotid fork.

3. elongation of A1.

4. no checkrein effect.

5. sylvian point & M.C.A.---normal.

Lateral view

1. posterior displacement of A.C.A.

2. vertical stretching of A2-A3.

3. stretching of frontopolar artery.

4. downward displacement of M2.

5. depression of candelabra artery.

6. closing of carotid siphon.

7. ophthalmic artery---normal.

Fronto-central

A-P view

1. round shift of A.C.A.---mild.

2. checkrein effect.

3. depression of M1.

4. flattening or mushroom appearence of carotid fork.

5. sylvian point---normal.

Lateral view

1. rectangular erection of C1-M1.

2. fight angle of C1-C2.

3. elevation of M2-M3.

4. P.C.A. & ant. choroidal artery---better filling and posterior-basal

bulging.

Fronto-lateral

A-P view

1. roundd shift of A.C.A.

2. infrequent checkrein effect.

3. flattening of carotid fork.

4. vertical stretching of C1.

5. sylvian point---normal.

Lateral view

1. mild stretching of A2-A3.

2. continuous line of C2-M2.

3. depression of M2.

4. Stretching of candelabra artery.

Fronto-basal

A. Subfrontal

A-P view

1. round or angular ahift of A.C.A.

2. flattening of carotid bifurcation.

3. no checkrein effect.

4. sylvian point---normal.

Lateral view

1. bowing and downward convexity of A.C.A.

2. closing of sylvian artery group.

3. depression of sylvian artery group.

4. enlargement of ophthalmic artery.

B. Inferior frontal

A-P view

1. same as subfrontal lesion midline shift of A.C.A.---mild.

Lateral view

1. bowing of A.C.A.

2. relative preservation of A.C.A. branches.

3. enlarged ophthalmic artery---mild.

4. depression or elevation of M2.