颈静脉孔区解剖.pptVIP

A: Normal view of the jugular foramen. Also shown are Cranial Nerves V, VII, and VIII. B: An intracranial meningioma with jugular foramen involvement is depicted. the tumor is posterior to the nerve roots (the most favorable situation). C: Drilling of the neural component of the jugular foramen is performed. D:Tumor within the jugular foramen can then be microdissected out. * transcondylar approach Angle of surgical approach pre, ASA to clivus before OC resection post, ASA to JT after OC resection. the far lateral transcondylar exposure was 17 ± 1 mm. * transcondylar approach，the jugular tubercle obstructs the anterior portion of the PICA aneurysm. B ：gentle retraction of the spinal accessory nerve revealing the neck of the aneurysm, which is covered partially by the jugular tubercle. C： the dura covering the jugular tubercle is incised and reflected posterior before drilling. * D ：drilling jugular tubercle, improved exposure of the anterior aspect of the aneurysm. The suction tip is used to retract and protect the spinal accessory nerve. E ： clip the aneurysm neck, with improved visualization and after reduction of the jugular tubercle. CI , continuous irrigation; JT , jugular tubercle; VA , vertebral artery * vagus and accessory nerves pass lateral to the osseous bridge and the inferior petrosal sinus descends below the bridge to open into the internal jugular vein hypoglossal canal and joins the glossopharyngeal, vagus, and accessory nerves below the jugular foramen in the interval between the internal carotid artery and internal jugular vein * * arachnoid opened to expose the glossopharyngeal, vagus, and accessory nerves entering the dura and passing through the intrajug