PubMed · 2036112
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1991. Pterional craniotomy.. https://pubmed.ncbi.nlm.nih.gov/2036112/
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The rectus abdominis muscle flap, combined with the external oblique fascia, were utilized in cranial-base reconstruction. In a wide defect caused by resection of a giant meningioma, the dura was reconstructed with the external oblique fascia and anterior sheath, and the cranial-base defect was reconstructed with the rectus abdominis muscle flap.
Patients undergoing craniotomies for intracerebral lesions are generally positioned in such a way that the lesion is highest in the field. For midline lesions alongside the falx, patients are commonly positioned on their backs for an anatomically symmetrical approach. We propose positioning the patient in the lateral decubitus position ipsilateral to the lesion to take advantage of gravity by allowing the brain to fall away from the midline, thus obviating the need for retraction. We have used this position in 15 cases of falcine and parafalcine tumors to great advantage, without encountering untoward operative or anesthetic complications.