城 泰輔、赤井卓也、富田隆浩、黒田 敏
脳外46: 877-882, 2018
The Long & Winding Road To Be A Neurosurgeon Vol. 46
Our resident, Dr. Taisuke Shiro published his first paper as follow:
Taisuke Shiro, Takuya Akai, Takahiro Tomita, Satoshi Kuroda
Three dimensional skull model with vascular structures for the occipital expansion in patients with developed occipital emissary veins.
No Shinkei Geka 46: 877-882, 2018
We report an application of three dimensional skull model with vascular structures for the occipital expansion in a patient with developed occipital emissary veins. A 15-year-old boy visited dentist for orthodontics, and was pointed out mid-face hypoplasia. He had ventriculo-peritoneal shunt at age of 10 months. At visit to our institution, he had exophthalmos, low visual acuity, reversed bite and developmental retardation. And he had sleep apnea and was supported by continuous positive airway pressure at night. Computed tomograms and magnetic resonance images demonstrated brachycephalus, chronic tonsillar herniation, midface hypoplasia, and well developed occipital emissary veins. We chose the occipital expansion for expecting lowering intracranial pressure, and made three dimensional skull model with vascular structures and shunt tube. On this model, we wrote scalp incision and craniotomy lines avoiding injury of veins and shunt tube. The operation was completed under this plan. Patients with syndromic craniosynostosis frequently have developed emissary veins and previous shunt operation. The three dimensional skull model with vascular structures will be expected to reduce operation risks.