Liliequist膜的显微外科解剖学研究

MICROSURGICAL ANATOMY OF LILIEQUIST'S MEMBRANE

目的:探讨Liliequist膜的显微解削及其手术意义.方法:在手术显微镜下观察6例尸脑的Lilequist膜,作解剖学观测.结果:Liliequist膜是前切迹空间的网膜结构,张于鞍背和动眼神经之间,分间脑膜和中脑膜两叶,伸向后上方和后(下)方,其大小、性状及后缘附着部位均有较大个体差异,同垂体柄和后交通动脉等有纤维连系.结论:该膜有维系鞍后诸结构相对空间位置的作用,间脑膜主要分隔视交叉池与脚间池,中脑膜主要分隔脚间池与桥前池,均是重要的手术标志和界面.经幕上达到基底动脉尖或上斜坡,需经过该膜,因无血管贯穿,可较安全地切开.

Objective To study the microsurgical anatomy of Liliequist's membrane and discuss its surgical significance. Methods Liliequist's membrane of 6 brains were observed using an operating microscope, and their anatomic structures were measured. Results Liliequist's membrane is an arachnoidal structure which stretches between dosum sellae and oculmotor nerves in anterior incisural space. It includes two sheets, diencephalic membrane and mesencephalic membrane. The former extends posterosuperiorly, and the latter extends posteriorly or posteroinferiorly. Their sizes, structures and the attaching sites of posterior edges vary greatly one another. There were trabeculate connections between diencephalic membrane and hypophyseal stalk or posterior communicating arteries. Conclusions The membranes could maintain the original locations of postosellar structure. The diencephalic membrane mainly seperates chiasmatic and interpeduncular cisterns, and the mesencephalic membrane manly separates interpeduncular and prepontine cisterns. Two sheets are both important landmarks and interfaces in operations. In the approach to basilar tip or upper clivus supratentorially, these membranes need passing through. Without perforating vessels, they could be incised safely.