壳核动脉的显微解剖研究及其临床意义

Microsurgical Anatomy of the Putaminal Arteries and Its Clinical Significance

目的观察壳核动脉的解剖学特征,为高血压脑出血好发于壳核的原因分析提供形态学依据。方法采用镜下解剖和脑血管铸型方法,对60侧脑标本、6例脑血管铸型标本壳核动脉的形态学特点进行观察。结果60侧大脑半球共观察到470支壳核动脉,平均每侧7.8±2.6支,其中80.6%来源于大脑中动脉;17.9%来源于大脑前动脉;1.5%来源于脉络膜前动脉。壳核动脉行程迂曲,在穿入壳核时尚形成弓状、环状弯曲,其直接形成直径<0.01mm分支的情况亦明显高于基底核区其它结构的供血动脉(P<0.01),且76%的壳核动脉起于大脑中动脉分叉处2mm范围内。结论壳核动脉的起源、行程以及其分支发出形式的解剖特点决定了壳核动脉在高血压情况下易破裂出血。

[Abstract] Objective To provide the morphological basis for explaining that hypertensive hemorrhage happen more often in the putamen than in the other struetures of the basal nuclei. Methods Thirty samples of the fixed cadaveric heads and 6 samples of the cercta＇al vascular cast, which were made of fresh cadaveric heads, were used. The putaminal arteries of the samples were observed and determined under a microscope. Results Four hundred and seventy putaminal arteries were found in 60 cerebral hemispheres （average： 7.8＋2.6 arteries per hemisphere, range： from 6 .to 14 arteries）. Based on their origin, these arteries were divided into three groups： 80.6% of the arteries derived from the middle cerebral artery （MCA）, 17.9% from the anterior cerebral artery （ACA）, and 1.5% from the anterior choroida] artery （AChA）. The putaminal arteries not only wound, but also tbrmed a bow-shape or circularity, when they perforated into the cerebral hemisheres. The fi＇equency of giving off directly the branches smaller than 0.01 mm in diameter was significantly higher in the putamina] arteries than that in the other arteries feeding to striatum and internal capsule （P〈0,01）. Conclusion The anatomy features of origin, route and giving off branches of putaminal Arteries are closely relate to the hypertensive cerebral hemorrhage which easily occurs in the putamen.