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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">わが国の脳神経外科が関与する領域は，諸外国では考えられないほど幅広く，膨大な量を占める．それぞれに対応する表面上の手技は多岐にわたるものの，本質にあるエッセンスはかなり共通するものである．本書は，単純な表面上の手技書ではなく，常にサイエンスを意識させ，手技の本質を理解させることにより，さまざまなイベントに臨機応変に対応できるようになることを目的とした1冊．</section><section class="preface">序文<br><br>　「脳神経外科診療プラクティス」シリーズは，橋本信夫国立循環器病研究センター理事長のご指導のもと，脳神経外科専門医に求められているものは何かという視点で発刊されることになりました．このシリーズは，ニューロサイエンスの視点を重視した意味で，他のシリーズとは一線を画すユニークなものです．<br>　今回，「脳神経外科の基本手技」を最初のタイトルの1 つとして取り上げました．脳神経外科は，基本診療科の1 つであり，そのカバーする範囲は，脳神経外科手術のみならず，救急医療からリハビリテーションまで及び，広大です．それは諸外国にはない，日本の脳神経外科の特徴であるとともに，大きな強みです．脳神経外科医として身につけるべき基本手技は，ベッドサイドの神経学的評価から始まり，救急蘇生法，麻酔方法，脳血管撮影をはじめとする侵襲的検査など，患者の安全に直結するものばかりです．術者としてデビューすると，毎日が緊張に満ちたものになりますが，同時に脳神経外科医としての醍醐味を味わうことができます．脳神経外科医が修得すべき知識や技術が多様化，高度化すればするほど，若い時に基本手技をどのような形で学ぶかが，かつてないほど重要となっています．<br>　本書は，脳神経外科の基本手技の中で，特に重要なものに絞って，そのエッセンスをエキスパートの先生に，豊富なイラストをもとに解説してもらう形で企画致しました．本書ですべての手技を取り上げているわけではありません．また各項目も詳細な解説を記載しているわけでもありません．しかし，基本手技の奥にあるエッセンスは，シンプルで美しく，共通したものが多いと思います．エキスパートの先生が，それをどのように伝えようとしているのか，その背後にある哲学といったものを学んでいただきたいと思います．多忙な臨床の合間に，本書を紐解けば，自分の経験が増すごとに新しい発見があると思います．今回の特集は，どの項目も，簡潔な文章，美しいイラストのため，つい読みいってしまう出来映えになっています．1 人でも多くの脳神経外科医が多忙な臨床の合間に，折にふれ，本書を手に取ることにより成長することができれば，編者として望外の喜びです．<br><br>九州大学　飯原弘二</section><section class="indexes">I. ベッドサイド基本手技<br>　1．救急蘇生処置<br>　2．感染予防・消毒・滅菌<br>　　【O】ドレッシング<br>　3．全身麻酔の方法<br>　4．局所麻酔のかけ方<br>　5．中心静脈穿刺<br>　6．腰椎穿刺・スパイナルドレナージ<br>　7．気管切開<br>　8．呼吸器合併症の管理<br>　9．動脈穿刺と動脈ラインの留置<br>　10．末梢静脈ライン確保とトラブルシューティング<br>II. 検査手技<br>　1．脳血管撮影<br>　　a．血管解剖と読影<br>　　b．手技<br>　2．脊髄血管撮影<br>　　　【O】脊髄造影<br>III. 基本手術手技－総論－<br>　1．体位の取り方─頭部の固定法─<br>　2．皮膚切開のバイオメカニクス─寄らない皮膚を寄せるには─<br>　　　【O】コロラドニードル<br>　3．止血と結紮<br>　4．縫合<br>　5．頭皮の外科解剖と皮弁のデザイン<br>　6．閉創<br>　7．形成外科に学ぶテクニック─術後の頭皮の治癒が遷延した時の治療法─<br>　8．血管外科に学ぶテクニック<br>IV. 基本手術手技－各論－<br>　1．穿頭術─慢性硬膜下血腫に対する穿頭血腫除去洗浄術─<br>　2．脳室穿刺法<br>　3．脳室腹腔シャント術<br>　　　【O】腰椎腹腔シャント術<br>　4．開頭術のドリリング─ドリルの種類，選択，持ち方─<br>　5．脊椎手術のドリリング<br>　6．前頭側頭開頭─整容の観点から─<br>　7．両側前頭開頭─整容の観点から─<br>　8．側頭下開頭<br>　9．外側後頭下開頭法<br>　10．正中後頭下開頭<br>　11．外減圧術<br>　12．頭蓋形成術<br>　13．頭蓋底外科の必須知識<br>　14．硬膜閉鎖と髄液漏予防<br>　15．再生医療の展望<br>V. マイクロサージェリー<br>　1．マイクロサージェリーの練習法<br>　2．手術用顕微鏡の使い方<br>　3．マイクロサージェリーに用いる器具<br>　4．脳べらと吸引管の使い方<br>　5．脳槽の開き方─pterional approach とinterhemispheric approach─<br>　6．微小血管の剝離法<br>　7．動脈遮断のコツとピットフォール（1）─脳動脈瘤，バイパス術を例に─<br>　8．動脈遮断のコツとピットフォール（2）─頸動脈内膜剝離術を例に─<br>　9．顕微鏡手術における止血法─脳動静脈奇形および脳内出血摘出術をもとに─<br>　10．顕微鏡手術における骨削除11．穿通枝の扱い<br>　12．脳動脈瘤手術<br>　13．微小血管吻合─浅側頭動脈（STA）-中大脳動脈（MCA）吻合術─<br>　　【O】もやもや病に対する血行再建術<br>　14．深部血管吻合<br>　　a．前方循環<br>　　b．後方循環<br>　15．脳実質内腫瘍摘出術<br>　16．脳実質外腫瘍の手術<br>　17．脊椎脊髄手術<br>　　a．脊椎前方到達法<br>　　b．後方到達法<br>　18．脊椎手術のバイオメカニクス<br>VI. 手術支援技術<br>　1．術中血管撮影の適応<br>　2．術中CT，MRIの応用<br>　3．術中ナビゲーションの活用法<br>　4．定位的脳内血腫吸引術<br>　5．神経内視鏡の活用法<br>　6．脳神経外科周術期における薬剤の使い方<br>　7．手術記録の書き方<br>索引<br><br>＊【O】：One point advice</section></article>
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