Heubner回返动脉的显微解剖及其临床意义

Microanatomical study of Heubner recurrent artery and its clinical significance

目的:研究Heubner回返动脉的显微解剖及其与A1的关系,以及与眶额动脉和额极动脉的区别。方法:成人尸体头颅标本15例(30侧),经翼点入路,在手术显微镜下对Heubner回返动脉及相关结构进行观察后,取出脑组织块,解剖观察和测量回返动脉、眶额动脉和额极动脉。结果:(1)根据回返动脉与A1的关系,将其分为:远外侧型占22.2%、周围型占69.4%、内侧型占8.3%。(2)回返动脉直径为(0.77±0.12)mm,绝大部分起源于前交通动脉周围2mm的大脑前动脉;眶额动脉的直径为(0.63±0.16)mm,均起源于A2段,距前交通动脉的距离平均(5.51±3.4)mm;额极动脉的直径为(0.66±0.18)mm,距前交通动脉的距离为(1.41±0.51)cm。结论:识别回返动脉并明确其与A1、眶额动脉和额极动脉的关系对手术中Heubner回返动脉的保护具有重要意义。

Objective: To provide microanatomical data for Heubner recurrent artery (HRA), explore its relationship with A1 segment, and distinguish it with orbitofrontal artery (OFA) and frontopolar artery (FPA). Methods: Fifteen cadaver heads were studied through pterion approach under the operating microscope. The HRA, OFA and FPA were identified and measured. Results: 1.HRA can be divided into three types according to its relation with A1: far outer type(22.2%), peripheral type(69.4%) and inner type(8.3%). 2. The mean diameter of HRA was about 0.77±0.12 mm. HRA always arose from the anterior cerebral artery nearing to ACoA . The mean diameter of OFA was about 0.63±0.16 mm, and the mean distance from ACoA to OFA was about 5.51 mm. The mean diameter of FPA was 0.66±0.18 mm, and the mean distance between ACoA and OFA 14.11 mm. Conclusions: The investigation of the relationship of HRA with A1 segment, OFA and FPA is meaningful for minimizing neurovascular damage caused by surgical procedures in this region.