脚间窝动脉的显微外科解剖

MICROSURGICAL ANATOMY OF THE ARTERY OF INTERPEDUNCULAR FOSSA

使用手术显微镜对24例成人脚间窝的动脉进行了观测.旁正中丘脑动脉穿后穿质前半,上旁正中中脑动脉穿后穿质后半,下旁正中中脑动脉穿中脑与脑桥连接处至中脑被盖的前部,前两者常以单干或共干起源于大脑后动脉.大脑后动脉共发出71干,由干分支入后穿质的动脉共241支,其中旁正中丘脑动脉90支,占37.34%,外径为0.51±0.01(0.20～0.80)mm,上旁正中中脑动脉151支,占62.66%,外径为0.25±0.01(0.10～0.42)mm.下旁正中中脑动共144支,其起源较复杂.本文讨论了脚间窝动脉的分型与丘脑综合征的关系以及Willis环后部穿血管与动脉瘤的外科手术的关系.

The arteries of human interpeduncular fossa in 24 adult brains were observed and measured under the operating microscopy.The paramedian thalamic arteries (PTA'S) penetrated the anterior half of the posterior perforated substance (PPS);the superior paramedian mesencephalic anteries (SPMA'S) penetrated the posterior half of the PPS;and the inferior paramedian mesencephalic arteries (IPMA'S) penetrated the anterior surface of the mesencephalic tegmentum.The PTA'S and SPMA'S originated as single or common trunks from the posterior cerebral artery (PCA).The 71 trunks arising from the PCA branched 241 arteries entering the PPS,of which 37.34% (90 branches,outer diameter 0.51±0.01mm) were the PTA'S and 62.66% (151 branches,outer diameter 0.25±0.01mm) were the SPMA'S.The origin of the IPMA'S (144 branches) was very complex.The relationship between the type of the interpeduncular arteries and thalamic syndromes and the relationship between the perforating branches of the posterior portion of Willis circle and the operation of aneurysm were discussed in this paper.