Microsurgical anatomy of the perforating arteries on the third ventricular floor

目的探讨第三脑室底穿通动脉的显微解剖,为该部位的手术提供解剖依据.方法 25具尸头标本,在4～40倍手术显微镜下观察第三脑室底穿通动脉的显微解剖关系,并计算其相关参数.结果第三脑室底穿通动脉源于颈内动脉、后交通动脉、大脑后动脉及基底动脉.根据其血管来源及走行,穿通动脉可分为:无分支、近端分支及远端分支型,其中以近端分支型的穿通动脉管径较大,分布区域较广.这些穿通动脉终止在相对较远的区域.(1)前部:视交叉、垂体柄及漏斗;(2)中部:乳头体及灰结节;(3)后部:后穿质及后颅窝;(4)外侧部:旁中线穿质及视束前部.在中线部位,穿通动脉与两侧的大脑后动脉重叠及吻合相对较少.结论第三脑室底穿通动脉可分为三型,其中近端分支型的穿通动脉管径较大,分布较广.了解这些解剖结构的特点,可避免在第三脑室底手术中损伤这些血管而造成严重的并发症.To study the microvascular anatomy of the perforating arteries on the third ventricular floor.The microanatomy of perforating arteries on the third ventricular floor in 25 cadaveric heads of adults was observed with 4 to 40-power surgical microscope.The perforating arteries on the third ventricular floor arose from the internal carotid, posterior communicating, posterior cerebral and basilar arteries, and could be divided into three patterns: no ramification, proximal ramification, and distal ramification, according to their vascular origin and course. The perforating arteries of proximal ramification pattern had larger diameter and broader distribution These perforating arteries terminated at relative distant area, including a) anterior part: the optic chiasm and stalk and infundibulum; b) middle part: mamillary body and tuber cinereum; c) posterior part: posterior perforated substance and posterior fossa; and d) lateral part: paramedian perforated substance and anterior portion of optic tract. In middle part overlap and anastosis of perforating artery with posterior communicating artery from both sides were relatively few.The perforating arteries on the third ventricular floor can be divided into three patterns. The proximal ramification pattern possesses larger diameter of the vessel and broader blood supply area on the third ventricular floor. Identification and preservation of these perforating arteries are important when surgery is being planed.PubMed中文核心期刊要目总览(PKU)中国科学引文数据库(CSCD)05304-3078