上颈性眩晕发生的颈交感神经及第2颈神经的解剖学因素观察

Study on the anatomical factors of cervical sympathetic nerve and second cervical nerve in the occurrence of upper cervical vertigo

目的明确颈上神经节(superior cervical ganglion,SCG)与第2颈神经及椎动脉的解剖关系,为临床诊治上颈性眩晕提供形态学基础。方法解剖15具(30侧)成人尸体标本,观察颈上神经节与C_(2)的交通支及至椎动脉的分支。结果5侧未见SCG与C_(2)之间存在神经连接;25侧存在神经连接,其中18侧存在迷走神经参与,7侧可见SCG分支支配椎动脉。SCG分支与C_(2)前支汇合后,交感神经纤维分别至C_(2)前、后支及椎动脉。结论SCG与C_(2)的交通支及其对椎动脉的支配关系,可为阐明上颈性眩晕发病机理及建立有效治疗方案提供重要解剖学依据。

Objective To demonstrate the anatomical relationship between superior cervical ganglion(SCG)and second cervical nerve(C_(2))and the innervated branch from SCG to vertebral artery,for providing anatomical basis for the clinical diagnosis of the upper cervical vertigo.Methods Fifteen adult cadavers(total 30 sides)were dissected to observe the communicating branches of SCG with C_(2) and the branches of the vertebral artery.Results There was no neural connection between SCG and C_(2) in 5 sides.There were neural connection between SCG and C_(2) in the remaining 25 sides,of which the vagus nerves were involved in 18 sides.The innervated branches were found from SCG to vertebral artery in 7 sides.After the SCG branch merged with the anterior branch of C_(2),the sympathetic nerve fibers were transferred to the anterior and posterior branches of C_(2) and the vertebral artery respectively.Conclusions The communicating branches of SCG and C_(2) and their dominant relationship to the vertebral artery can provide important anatomical basis for elucidating the pathogenesis of upper cervical vertigo and establishing effective treatment plan.