鞍区蛛网膜的显微外科解剖学研究

Microsurgical anatomy of the arachnoid membranes in the sellar region

目的:了解鞍区蛛网膜的解剖学特点,为鞍区病变的显微手术提供解剖学依据。方法:采用显微外科技术解剖和观察8例脑标本鞍区蛛网膜。结果:鞍区蛛网膜包括颈内动脉内侧蛛网膜、颈内动脉外侧蛛网膜、后交通蛛网膜、脉络膜前蛛网膜、大脑前蛛网膜、视交叉蛛网膜、Liliequist膜、外侧裂蛛网膜、嗅神经蛛网膜、基底动脉分叉蛛网膜、后穿蛛网膜和动眼神经外侧蛛网膜,分割鞍区蛛网膜下腔,与下丘脑和动眼神经关系密切。结论:(1)颅内蛛网膜分为颅底蛛网膜、凸面蛛网膜和小梁蛛网膜;(2)鞍区蛛网膜与下丘脑关系密切,手术时强调锐性分离;(3)鞍区蛛网膜汇聚于动眼神经,为术中解剖和保护动眼神经提供了可靠的界面。

Objective: To investigate the anatomical characteristics of the arachnoid membranes in the sellar region. Methods: The arachnoid membranes were studied in eight adult human cadaveric specimens under microscope. Results: The arachnoid membranes included the medial membrane of internal carotid, the lateral membrane of internal carotid! the posterior communicating membrane, the anterior choroidal membrane, the anterior cerebral membrane; the olfactory membrane, the chiamatic membrane, the lateral oculomoter membrane , the sylvian membrane, the basilar artery bifurcation membrane, the posterior perforated membrane and Lilipuisfs membrane. They attached closely to the hypothalamus and the oculomotor nerves. Conclusions: Intracranial arachnoid membranes can be divided into the basal arachnoid membrane, the convex arachnoid membrane and the trabecular arachnoid membrane. The arachnoid membranes in the sellar region, which attach closely to the hypothalamus, should be opened sharply in order to avoid the injuries to the hypothalamus by blunt operations. Several arachnoid membranes converge on the oculomotor nerves and provide an important guide for the preservation of the nerves during surgery.