Heubner返动脉的显微解剖研究

Microanatomical study of Heubner recurrent artery

目的 :为有关鞍区手术提供Heubner返动脉的显微外科解剖资料。方法 :应用手术显微镜对 3 2例Heubner返动脉进行解剖学观察、测量。结果 :返动脉恒定存在 ,起源于大脑前动脉或其分支 ,单支型90 .6% ,双支型 9.4% ;返动脉主干平均长度为 2 9.4mm ,起始处平均管径为 1.0 2mm ;5 7%于大脑前动脉外侧向后行走 ,89%行于颈内动脉床突上段上方 ,17%贴附于颈内动脉床突上段内侧缘后行 ,86%于前床突与大脑前动脉之间跨越视神经上方 ,10 0 %从视交叉外侧缘外侧通过 ;77%在外侧裂池与颈动脉池交界处出现”U”形虹吸部 ;80 %出现粗大终支从前穿质进入基底节区。结论 :深入了解返动脉的解剖学特点及其与鞍区各结构的解剖关系 ,对于Willis动脉环动脉瘤的合理处置及经眶、经翼点入路鞍区手术神经血管的保护有重要的意义。

Objective: To provide the microanatomical details of Heubner recurrent artery for correlated operations. Methods: In this study-thirty two cases of adult cadavers were used for the observation and measurement of Heubner recurrent artery (HRA) under the surgical microscope. Results: The HRA presented constantly in each case and originated from the anterior cerebral artery or its branches. 90.6% of cadavers sent out single branch on each side of the brain, while 9.4% have two branches on either one or both sides. The average length of the HRA is 29.4 mm, the average diameter 1.02 mm at its originating site. Most of the HRA run along the anterior cerebral arteries laterally,and then turn back along the optic chiasmas laterally, and form an 'U' shape curve under the anterior perforated substance. The greater terminal branchs of HRA entered into the basal ganglion region through the anterior part of the anterior perforated substance in 80% of cases. Conclusion: These findings indicate that more detail anatomical informations about HRA are necessary for operations of sella turcica region. Some useful suggestions have been demonstrated in our discussion part.