[Three-dimensional images of petrosal veins for preoperative evaluation: four case reports].

BACKGROUND

In the surgeries of the upper part of the cerebellopontine angle (CPA), the petrosal vein (PV) is an obstacle, and the resection of the PV sometimes causes postoperative complications such as cerebellar hemorrhagic infarction. On the other hand, it can be an anatomical landmark during the surgery. We have used three-dimensional (3D) CT images for preoperative evaluation. We, herein, report 4 cases of CPA lesions.

METHOD: The PV was imaged with neighboring structures using CT and a workstation. We paid attention especially to the vein of the cerebellopontine fissure (VCPF).

RESULT: The four cases include one case of trigeminal neuralgia, two meningiomas and one case of acoustic schwannoma. 3D CT images showed (1) the anatomical formation such as course of the PV, (2) relationship to the neighboring structures of the tumors, (3) expectation of complications after sacrificing the PV. By observing the preoperative 3D CT images, we were able to plan safety operative approaches and procedures.

CONCLUSION

3D CT images of the PV are very useful for preoperative evaluation of surgery in CPA lesions.