目的：本文的目的是评估幕上-枕下（STIO）方法在脑血管神经外科手术中的应用。
方法：作者对研究期间使用STIO方法的所有连续病例进行了队列研究，1995年12月至2021年1月，以及系统的文献综述。
结果：确定了25例使用STIO方法的脑血管病例。诊断包括动静脉畸形（n=15），脑海绵状畸形（n=5），动静脉瘘（n=4），和动脉瘤（n=1）。动静脉畸形包括Spetzler-MartinII级（n=3），三级(n=8)，和IV级（n=4）病变。病变部位包括枕叶（n=15），其次是小脑膜(n=4)，颞枕骨（n=3），时间(n=1)，丘脑（n=1），和四叉水箱（n=1）区域。许多患者（75％）由于枕叶退缩而出现一过性视力障碍，所有这些都解决了。截至上次随访（n=12），与术前基线相比,6例患者改良Rankin量表评分有所改善,6例患者评分无变化.
结论：STIO方法是一种安全有效的颅底方法，为适当选择的脑血管病变提供了专门的通道。
The objective of this paper was to assess applications of the supratentorial-infraoccipital (STIO) approach for cerebrovascular neurosurgery.
The authors conducted a cohort
study of all consecutive cases in which the STIO approach was used during the
study period, December 1995 to January 2021, as well as a systematic review of the literature.
Twenty-five cerebrovascular cases were identified in which the STIO approach was used. Diagnoses included arteriovenous malformation (n = 15), cerebral cavernous malformation (n = 5), arteriovenous fistula (n = 4), and aneurysm (n = 1). The arteriovenous malformations consisted of Spetzler-Martin grade II (n = 3), grade III (n = 8), and grade IV (n = 4) lesions. Lesion locations included the occipital lobe (n = 15), followed by the tentorial dural (n = 4), temporal-occipital (n = 3), temporal (n = 1), thalamic (n = 1), and quadrigeminal cistern (n = 1) regions. Many patients (75%) experienced transient visual deficits attributable to retraction of the occipital lobe, all of which resolved. As of last follow-up (n = 12), modified Rankin Scale scores had improved for 6 patients and were unchanged for 6 patients compared with the preoperative baseline.
The STIO approach is a safe and effective skull base approach that provides a specialized access corridor for appropriately selected cerebrovascular lesions.
