人脑桥静脉及蛛网膜的显微解剖研究

目的观察人6脑桥静脉在显微解剖、显微结构的形态学特征,分析人脑桥静脉与蛛网膜的关系,为显微神经外科手术入路方案的制定、脑静脉系在手术中的保护提供形态学依据。方法将20例(40侧)成人脑标本的桥静脉分为上矢状窦组、小脑幕上组、蝶骨组和颅后窝组4组进行显微解剖观测。结果①上矢状窦前部和后部各有一缺乏桥静脉注入段;②小脑幕上组桥静脉注入处的形态分为单干型、多干型和烛台型。③大脑中浅静脉表现为单干、双干或三干。④颅后窝组桥静脉可分为窦汇组、小脑幕组和岩部组3组;⑤所有桥静脉均可以观察到静脉从蛛网膜下腔穿出,蛛网膜包裹静脉并在其表面形成袖套样结构。结论熟悉桥静脉的形态特征,有助于神经外科手术入路的选择和手术过程中更好地保护桥静脉,避免术后并发症的发生;妥当处理桥静脉表面的蛛网膜袖套对于静脉保护具有重大的意义。

Microsurgical anatomy of cerebral bridging veins and their arachnoid membranes

Objective To study micro-anatomical features of cerebral veins and their arachnoid membranes.Methods The cerebral bridging veins were divided into four groups: superior sagittal group,supratentorial group,sphenoidal group and posterior fossa group in 20 cadaveric brains using an operating microscope.Results Anterior and posterior of superior sagittal sinus have a sagement void of bridging vein draining into respectively.The configuration of the location of termination yields three types: single vein type,separated type,candelabra type.The superficial middle cerebral veins were classified into three types according to the number of stems draining into the dural sinussingle stem,double stems and three stems.The bridging veins of the posterior fossa group divided as confluence group,tentorial group and petral group.Arachnoid membranes packaged the cerebral bridging vein and formed as arachnoidal envelope.Conclusion The communications and relationships between cerebral veins as well as their arachnoid membranes were redefined in this study.