人外侧膝状体的血液供应及其临床意义

Blood supply of human lateral geniculate body and its clinical significance

目的:为外侧膝状体(LGB)缺血所致的视野缺损提供形态学依据。方法:手术显微镜下观察成人和胎儿脑的LGB动脉的来源和微血管构筑,部分脑标本用组织切片方法观察营养LGB动脉的粥样硬化病理改变。结果:LGB营养动脉第一级来自颈内动脉和大脑后动脉,二级为脉络丛前动脉、脉络丛后外动脉和丘脑膝状体动脉,三级构成LGB的小动脉。50岁以上的标本,LGB 的一、二级动脉有硬化改变的占88%,二级小动脉被阻塞占10%。结论:二级动脉在LGB内有各自的供血区,脉络丛前动脉是供应IGB前部和外侧部的唯一动脉,大脑后动脉营养LGB的其余部分。不同动脉的阻塞可导致不同种类的视野改变,是视野缺损的原因之一。

To provide morphological evidences for visual field defect caused by ischemia of LGB. Methods： The arteries origin and vascularization of the lateral geniculate body （LGB） in adult and fetus brains was observed by microscope. The 60 brains （60 to 80 years old） were sliced up to look for the atherosclerotic pathology of arteries supplying LGB. Results： The arteries supplying LGB were divided into 3 grades. The first-grade artery were from internal carotid artery and posterior cerebral artery; the anterior choroidal artery, postero-lateral cboroidal artery and thalamogeniculates artery were the second-grade arteries; the third-grade artery was arteriolar branches of the LGB. A schematic diagram had been devised which showed that visual field disruption could identify the arterial system involved. Pathophysiological examination revealed 88. 3% of the internal carotid and posterior cerebral artery irrigating in LGB with atherosclerosis in 60 cerebral hemispheres. The second-grade arteries block was 10%. Conclusion： The second-grade arteries supply their specific area of LGB; the front part and lateral part of LGB is supplied with one-origin anterior cboroidal artery; the rest of LGB are supplied with posterior cerebral artery.