大脑内静脉及其属支的显微解剖研究

Microsurgical anatomy of the cerebral internal vein and its tributaries

目的对手术中涉及的大脑内静脉及其属支进行显微外科解剖研究。方法20例脑标本,应用显微镜对大脑内静脉及其属支进行解剖、观察和测量。结果大脑内静脉通常由丘纹静脉、透明膈静脉和脉络膜上静脉在室间孔后缘汇合形成,存在解剖变异。双侧大脑内静脉基本位于同一水平面,但非所有如此。根据大脑内静脉与松果体的方位,可将大脑内静脉分为4型。静脉角与室间孔的距离变异较大。丘纹静脉可分为正常型和异常型6种。脉络膜后内侧动脉与大脑内静脉密切联系。结论大脑内静脉的主要属支之间有解剖的互补性。大脑内静脉及其属支可作为解剖标志。侧脑室手术中应注意双侧大脑内静脉不平行的可能,保护好大脑内静脉及其属支以及伴行的动脉。大脑内静脉及其属支的解剖关系和变异,对选择扩大Monro孔的手术方法具有决定性意义。

Objective To investigate the microsurgical anatomy of the cerebral internal vein(CIV)and its tributaries,which are related to the operation in the lateral and third ventricle.Method20formalin fixed adult cadaveric brains(forty hemispheres)were evaluated under ZEISS brand operating microscope.The CIV and its tributaries were dissected and studied.Result CIV was formed mainly by thalamostriate superior vein,septum pellucidum vein and choroidal superior vein.There was anatomical variation.In most specimens,the left and the right CIV run at the top of the third ventricle in the same horizontal plane.But the anatomical variation existed.CIV could be separated into four types according to its directional relationship with pineal body.The distance between foramen of Monro and venous angle varied obviously.Thalamostriate superior vein was classified into normal and abnormal in six kinds.It is important that posterior-medial choroid artery ties up with CIV.Con clu sion CIV and its tributaries must be protected carefully during the operation.Posterior-medial choroid artery must be taken care of,too.CIV and its tributaries are the nice landmarks in operation of lateral ventricle.How to enlarge the foramen of Monro?The anatomical variation of CIV and its tributaries plays the key role in choosing the operation plan.