大脑中动脉中央支脑外段的解剖学观察

A Anatomy Study on the Extracerebral Segements of the Central Branches of the Middle Cerebral Artery

用手术显微镜和双目解剖镜,观测了67个(成人30、儿童16、胎儿21)固定脑的大脑中动脉中央支脑外段。共有中央支900条,每侧平均6.73±0.49(1～18)支。内、外侧群均各以2～3支最多见。内侧群80%以上以直角或锐角从大脑中动脉分叉前发出;外侧群几乎都以锐角从主干、分叉处发出。外侧群中央支虽略粗,但与内侧群间无显著差异。中央支脑外段呈S形走向,入脑后将重新排列为前内和后外的矢状位扇形外观。本文还对中央支血管壁的组织结构特点进行了观察,讨论了中央支脑外段解剖特征与脑动脉瘤手术和脑血管病理学的关系。

Extracerebral Segements of the central branches of the MCA were observered and measured in 67 (adult 30, children, 16, fetal 21) fixed brain by operation microscopy and stereoscopic microscope. 900 central branches were recorded. The central branches varied in number 1 to 18,with an average of 6.8 in each hemisphere. There were usually 2 to 3 vessels in medial or lateral group. Thoscd in the MG usually arose directly from the MCA main trunk close to the carotid bifurcation. Those in the LG had their origin as follow: main trank, bifurcation and so on. The angle of origin was variable for the MG in right, acute,or parallel. Those in the LG were usually acute. Because the cxtracerebral segements ran toward the anterior perforating substance in S-Shaped curves, the rearrangment of the intracerebral sagements began and formed fan-shaped appearance in rostalmedial and caudallateral state. Morphological structure of vascular wall were examined under olympus micro-scopy. Circularly-oricnted smooth muscular cells were found nobifurcation area. The essay discussed the relationship between microanatomy of the extraccrcbral scgcmcnts of the central branches and operation of cerebral aneurysms, pathology of cerebral vessels.