Thalamic arterial pattern: An endocast and scanning electron microscopic study in normotensive male rats

Rat cerebral vasculature serves as a model for study of the pathophysiology of stroke in humans. Human thalamic anteries show a high incidence of stroke. The objective is to describe the thalamic arterial vascular pattern in normotensive male rats as the initial step for quantitative histochemical studies of enzyme activities in the walls of these vessels. Intracardiac injections of methyl methacrylate monomer provide detailed vascular endocasts. The thalamic vascular bed defined by in situ dissection, serial reconstruction, and light and scanning electron microscopy of endocasts contained four groups of vessels: (1) ventral medial thalamic arteries, (2) thalamic branches from the posterior cerebral artery, and (3) ventral lateral and (4) ventral anterior thalamic arteries. Thalamic vessels are muscular arterioles that, after three to four bipinnate branches, feed into a continuous capillary bed (no loops). The parent vessels and their subsequent branches have been evaluated in terms of their mean internal diameters, mean interbranch intervals, and branch angles. The arterial patterns to rat and human thalami are very similar, with the exception of the anterior choroidal artery which is missing in the rat. The branches supplying the thalamus in both the rat and human are closely associated with the circle of Willis; however, the constituent parts of the circle in rat vary from the pattern in human brain. The rat thalamic arteries show morphological features similar to those seen in the stroke-prone ganglionic arteries in the human basal ganglia.     

Angiology of the brain of the baboon Papio ursinus,the vervet monkey Cercopithecus pygerithrus,and the bushbaby Galago senegalensis

The investigation was undertaken to compare the blood supply and venous drainage of the brain of the baboon P. ursinus, the vervet monkey C. pygerithrus, and the bushbaby G. senegalensis with that of man, because these animals are extensively used as research models. The blood supply of the three primates was found to be similar in each case. Like man they have a complete circulus arteriosus; but they have a single anterior cerebral artery, whereas man has paired anterior cerebral arteries. The arterial supply to the cerebellum in the primates is similar to that in man, the main difference being a “common inferior cerebellar artery” which bifurcates to form the anterior inferior cerebellar and posterior inferior cerebellar arteries. In man, these arteries arise separately from the basilar artery and vertebral arteries, respectively. The dural venous drainage was also found to be similar in these primates but was far more extensive than in man. The primates have additional sinuses–the more important of these being the “basisphenoid sinus” and the petrosquamous sinus. The former drains the basilar sinus and is itself drained via the vertebral venous plexus and internal jugular vein. The latter drains via the petrosquamous foramen into the retromandibular vein. The petrosquamous sinus has a rostral extension which drains through the foramen ovale and two lateral and medial connecting sinuses which drain the cavernous and basilar sinuses, respectively. These sinuses are not found in man.     

老年人内侧膝状体形态、血供和来源动脉的病理学改变

目的 :研究老年人内侧膝状体的形态、毗邻及供血动脉来源、分支、分布和病理改变。方法 :体视及手术显微镜下观察 60～ 80岁年龄的脑内侧膝状体的形态、毗邻和血供情况 ;取内侧膝状体来源动脉 (大脑后动脉 )光镜下观察动脉壁的病理改变情况。结果 :内侧膝状体呈半球形 ,动脉来源于大脑后动脉的分支 ,即丘脑膝状体动脉 ,脉络丛后内、外动脉和丘体动脉 ,每侧有小动脉 ( 6.8± 1 .5 )支 ,大脑后动脉粥样硬化改变者占 88.3 %。结论 :内侧膝状体动脉细小 ,仅由大脑后动脉供血 ,动脉硬化可致小动脉管腔狭窄 ,供血不足 ,可能是老年人听力下降的原因之一。     

Variations in collateral contributions to the blood supply to the sternum

The blood supply of the sternum plays a major role in healing of the sternum after sternotomy. The sternal blood supply is derived mainly from the medial horizontal branches of the internal thoracic artery (ITA). The ITA is usually described as giving off sternal, anterior intercostal and perforating branches supplying their respective areas. The aim of the present study was to describe variations in the arterial branching pattern of collateral contributions to the sternum. The study was conducted on 30 fresh specimens of anterior thoracic wall in which cellulose acetate butyrate was injected into the ITA. The branches of the ITA in the first to sixth intercostal spaces were dissected and any additional artery supplying the sternum in each intercostal space was observed. In the present study, the ITA gave off non-collateral branches - sternal, anterior intercostal and perforating. The ITA was also found to have branches which divided into two to supply two destinations which could establish collateral flow to the sternum: (1). A sterno-intercostal branch (1-12 mm in length) divided and diverged in a Y or T shape. The medial limb supplied the sternum and the lateral limb supplied the adjoining thoracic wall, anastomosing with the terminal part of the posterior intercostal artery. (2). A sterno-perforating branch supplied the sternum either anteriorly or posteriorly before perforating and supplying the pectoral region and anastomosing with the thoracoacromial artery. This study reinforces the practice of ligating branches of the ITA close to its trunk as they have the potential to develop collateral blood supply. In the present study the posterior intercostal artery was at times found to supply the sternum directly or via its collateral branch and was named the persistent posterior intercostal artery.     

后丘脑动脉的显微解剖及其微血管构筑

用手术显微镜观测了４８例成人后丘脑的动脉，并用墨汁明胶灌注，厚片透明，碱性磷酸酶染色示血管内皮及甲酯铸型法，在体视显微镜和扫描电镜下观察了１４例胎儿后丘脑的微血管构筑。后丘脑的动脉分为内侧膝状体丘脑动脉，外侧膝状体丘脑动脉和膝状体间丘脑动脉。     

The arterial supply to the brain of the yak (Bos grunniens)

Fifteen head specimens of the yak were dissected to study the arterial supply to the brain. The supply comes from the internal carotid, maxillary, occipital and vertebral arteries. Except for the internal carotid artery, the branches of the above-mentioned arteries contributed in the formation of the rete mirable of which the vascular diameter was larger and the wall was thinner. The brain was mainly supplied by branches from the internal carotid and vertebral arteries in which the blood is oxygenated. These branches joined to form the circle of Willis (Circulus arterious cerebri) in the region of the pituitary gland. The arterial supply to the cerebrum was mainly provided by the middle and rostral cerebral arteries, which arose from the internal carotid. The basilar, cerebellar and caudal cerebral arteries came from the vertebral artery. However, the adult yaks do not have the rostral communicating artery. The outer diameter at the origin of the vessels ranged from 0.40 to 2.60 mm. The outer diameter of the left arterial vessel at its origin was larger than the same vessel of the right by about 0.20 mm in the all samples.     

小腿后部穿支的3D可视化研究与皮瓣设计

目的：运用血管造影及其数字化模型探讨小腿后部各区穿支间的关系,为穿支皮瓣的临床应用提供解剖学依据。方法：（1）8具新鲜成人整尸,采用改良的氧化铅配方行一次性全身动脉造影。其中2具行连续螺旋CT扫描,对小腿进行三维重建。（2）将小腿后部分为上、中、下3区,层次解剖并配合x线摄影,观测各区穿支的定位、直径、走行、分支及其相互之间的吻合状况。结果：小腿后部共有外径≥0．5mm穿支（13±2．3）支,平均外径（0．8±0．2）mm,平均供血面积（38±9．0）cm2。上区的胭动脉穿支位置恒定且较粗大,向下与中区的胫后动脉、腓动脉之穿支形成不减少口径的真性吻合,其单穿支供血面积高达（55±20）cm2;下区穿支较细,沿跟腱两侧呈链状分布,向上与中区的穿支吻合。结论：小腿后部为良好的穿支皮瓣供区,中区可切取穿支皮瓣游离移植,上区与下区可分别切取近端蒂与远端蒂穿支皮瓣。     

内踝区动脉网的显微解剖与隐神经营养血管远端蒂皮瓣的设计

目的：为隐神经营养血管远端蒂皮瓣设计提出解剖学依据。方法：30侧经动脉灌注红色乳胶成年下肢标本，解剖观测内踝区动脉来源、分支、分布及吻合。结果：内踝区动脉有9个来源，构成3条纵向的血管网：(1)内踝前动脉和踝上支的前纵向血管网；(2)骨皮穿支的中纵向血管网；(3)胫后动脉肌间隙支和踝管动脉穿支的后纵向血管网。形成3个层面的血管网：(1)骨膜血管网；(2)深筋膜血管网；(3)皮神经浅静脉血管网。内踝区骨膜、筋膜、大隐静脉、隐神经和皮肤的营养血管同源。结论：内踝区血供来源为多源性，有明显的方向性，吻合十分丰富，可以设计3种包含浅深筋膜、皮神经、浅静脉及其营养血管的小腿内侧远端蒂皮瓣：(1)以胫后动脉肌间隙支为蒂，旋转轴点在内踝最凸出点上3cm；(2)以内踝前动脉筋膜穿支为蒂；(3)以踝管区动脉穿支为蒂，旋转轴点在内踝最凸出点平面。     

Vascular ontogeny of the septal region in rats.

The development of the arterial and venous systems of the septum was studied in rat brains injected daily with India ink, from the 11th embryonic (E) until the first postnatal day. Arterial blood is supplied to the septum by the unpaired hemispheric artery, the stem and septal branches of which are to be recognized on the 14th and 15th embryonic days respectively. At earlier stages, e.g. on E12, a capillary network, the hemispheric plexus, can be seen between the two hemispheres contributing to the blood supply of the septum during the early phase (E14 to E18) of development. From E18 onwards, the arterial supply of the septum is derived only from direct branches of the hemispheric artery; one group of them being dorsal (infracallosal) and the other ventral (subcallosal). The venous drainage of the septum is bidirectional: 1) Veins of the ventral group leading to the interperioptic sinus are seen on E14. At first they collect blood only from a small rostral portion of the septum, but later their territory expands to include the anteroventral two-thirds of the septum. 2) The dorsal septal veins drain into the great cerebral vein (of Galen), or into the superior sagittal sinus directly. Initially, twigs run directly into the great cerebral vein. These later become the tributaries of the internal cerebral vein, which appears on E17 or E18. Until E18 this dorsally-directed drainage predominates, whereas at birth it becomes restricted to one third of the septum as a result of a gradual regression. The development of both arterial and venous circulations of the septum is complete at birth.     

Extraneural arterial blood vessels of human fetal sciatic nerve

Nerves get segmental blood supply either from the neighboring muscular and cutaneous branches or from the regional main arterial trunks. The aim of our research was to detect, in the gluteal and posterior femoral region, the blood vessels which are involved in the blood supply of the human fetal sciatic nerve, as well as to establish their origin. Micro-dissection was performed on 48 fetal lower extremities which were previously fixed in 10% formalin. Micropaque solution (barium sulfate) was injected into their blood vessels. The fetal gestational age was established by measuring the crump-crown length and it ranged from the third to the ninth lunar month. The observed nutritional arteries of the human sciatic nerve originated from the inferior gluteal artery, medial circumflex femoral artery, perforating branches, and popliteal artery. The anastomotic arterial chain of the human sciatic nerve was observed in all cases. In 75% of the cases it was composed of the branches of the inferior gluteal artery, the medial circumflex femoral artery and the first two perforating arteries. The nutrient branch of the third perforating branch was less frequently (in 14.5% of the cases) part of this anastomotic arterial chain.     

Internal Ophthalmic Arteries Within the Brain‐Base Arterial System in Guinea Pig

In situ vascular specimens of the arterial circle were collected from 15 adult guinea pigs, both male and female. After specimen preparation, the vessels were filled with synthetic latex and subjected to analysis. Similar as in the case of other rodents, vertebral arteries were merged into basilar artery, further dividing into two short terminal branches. Distally, the terminal branches extend into caudal cerebral arteries. Rostral part of the arterial circle of brain is supplied with blood from maxillary arteries via external and internal ophthalmic arteries connected by a short anastomosis. This type of vascularity may probably be considered a functional analogy to the internal carotid arteries observed in other species. Rostral and caudal parts of the arterial circle of brain are connected by exceptionally long caudal communicating arteries. In author's opinion, the disputable contribution of internal carotid artery and the exceptional contribution of internal ophthalmic arteries in the cerebral blood supply in guinea pigs as compared to other rodents, warrants further research on the subject. Anat Rec, 301:887–891, 2018. © 2017 Wiley Periodicals, Inc.     

大脑中动脉供血区脑缺血后同侧丘脑继发性损害的MR实验研究

本文应用磁共振(magnetic resonance,MR)成像在体观察大脑中动脉(middle cerebral artery,MCA)供血区脑缺血后同侧丘脑的信号变化。结果显示:(1)通过MRA(magnetic resonance angiography)可以观测到单侧MCA的闭塞与血流再通,而供应丘脑的大脑后动脉信号无变化;(2)脑缺血后1d MR T2WI(T2weighted imaging)显示单侧MCA供血区原发病灶呈高信号,3d、7d时此原发病灶信号增高程度有所降低,至14d信号强度再次明显增高;(3)脑缺血后1d和3d时双侧丘脑T2信号无差别,7d和14d时脑缺血同侧丘脑T2信号减低,T2值降低;(4)MCA供血区脑缺血后原发病灶和同侧丘脑T2值的变化不同步。上述结果证实MR能够在活体显示MCA供血区脑缺血后同侧丘脑的继发性损害。     

Arterial and Venous Brain Reactivity in the Acute Period of Cerebral Concussion

Transcranial color duplex scanning of the cerebral vessels was used to study arterial and venous reactivity in 38 patients in the acute period of cerebral concussion (CC) and in 32 healthy volunteers. Arterial flow was assessed in the middle cerebral artery (MCA) and venous drainage in the basal vein of Rosenthal (BV). Cerebrovascular reactivity was assessed using hypercapnic and orthostatic tests. These studies showed that CC was not accompanied by marked changes in cerebral hemodynamics in the state of rest. During the acute phase of CC, about 20% of patients showed increases in peak blood flow velocity in the MCA, typical of cerebral hyperperfusion. Increases in the peak blood flow velocity in the BV were seen in 25% of patients with CC, compensating for impaired drainage via the superficial cerebral system. In normal subjects, cerebral venous reactivity to hypercapnia was greater than arterial reactivity, while reactivity to orthostasis corresponded to the magnitudes of arterial changes. The absence of quantitative differences in the responses of arterial and venous blood flow to hypercapnia and the predominance of venous reactivity to orthostasis in patients with CC indicates that these patients had impairments in the regulation of venous tone.     

穿支皮瓣Choke区动、静脉血流阻力对皮瓣存活的影响

目的　通过在同一组皮瓣中对choke血管的动、静脉阻力进行比较研究,探究血流跨过choke血管的动、静脉阻力大小关系及其对皮瓣存活的影响。 方法　将34只SD大鼠随机分成两组,A组保留右侧肋间后动脉+左侧肋间后静脉,B组保留右侧肋间后动脉+右侧髂腰静脉。测量保留的动、静脉之间的距离。术后7天,统计皮瓣存活率以及血管造影观察皮瓣区微血管形态;choke区取材,H&E染色,计算平均微血管密度;尾静脉采血,检测乳酸含量。 结果　A组保留的动、静脉之间的距离比B组短[(2.5±0.3) cm vs (3.7±0.2) cm,t=14.608,P<0.05）]。术后7 d,A组皮瓣存活率为100%,B组1号血管体区存活率为（67.0±13.1）%,4号血管体区的为100%,整块皮瓣存活率为（88.0±6.8）%;A组比B组血管增生明显[（24.0±3.9）vs (17.6±4.3),t=2.727,P=0.021];A组与B组乳酸均接近术前水平,差异无统计学意义[（8.0±0.8）mmol/L vs (8.4±0.4) mmol/L vs (7.5±0.6) mmol/L,P>0.05]。 结论　①血流跨过choke血管的静脉阻力大于动脉阻力;②缩短跨choke区的动、静脉血流单向距离有利于减小跨choke区所受的静脉阻力,提高皮瓣的存活率。     

颊肌的解剖学研究及其临床意义

目的：阐明颊肌的血液供应,为新型颊肌粘膜瓣设计提供解剖学基础。方法：对10具新鲜尸体标本20侧面区进行解剖,从颈总动脉远心端注入红色乳胶,在2具尸体标本面静脉内注入兰色乳胶。显露颊肌及其血管和神经。结果：面动脉分别发出后颊支、下颊支和前颊支进入颊肌,后颊与颊动脉相互吻合。上齿槽后动脉和眶下动脉发出上颊支分别进入颊肌上界的后部与前部。这些分支相互吻合。颊肌静脉在颊肌后部形成颊静脉丛,分2～4支注入面静脉,或经颊静脉注入翼丛或上颌静脉。结论：面动脉为颊肌的主要供血动脉。以进入颊肌任何一方血管为蒂的颊肌粘膜瓣均可存活。本文设计了2种新的岛状颊肌粘膜瓣。     

联体皮瓣的静脉引流位置对动脉血流导向功能的影响

目的 探讨联体皮瓣的静脉引流位置对动脉血流导向功能的影响。方法 将72只SD大鼠随机分为4组:正常组不做任何处理;对照组仅保留右侧肋间后动、静脉;实验组1仅保留右侧肋间后动脉+左侧肋间后静脉;实验组2仅保留右侧肋间后动脉+左侧髂腰静脉。测量血管体之间距离。术后7 d,统计皮瓣存活率以及明胶氧化铅血管造影观察皮瓣区血管形态;choke 1区取材,HE染色,分析动脉管径扩大倍数;尾静脉采血,检测乳酸含量。结果 血管体Ⅰ离Ⅱ最近,离Ⅲ最远,差异有统计学意义（P<0.05）。术后7 d,对照组皮瓣存活率为（86.5±4.3）%,实验组1和实验组2皮瓣存活率均为100%;血管造影显示,在血管体Ⅲ与Ⅳ区域,对照组血管增生比较少,而实验组1比较明显,实验组2最明显;与正常组相比,实验组2动脉管径扩大最明显,其次为实验组1,差异有统计学意义（P<0.05）;对照组乳酸含量最高,差异有统计学意义（P<0.05）。结论 静脉引流位置的改变可造成动脉灌流与静脉引流效果的改变,进而改变皮瓣区域生理性血管网,提高存活率。     

Therapeutic embolization of the dural arteriovenous malformation involving the jugular bulb

Pulsatile tinnitus is a rarely occurring symptom of vascular origin. Most frequently, the symptoms are due to an arteriovenous malformation, to a tumor of the jugular glomus or to a local arterial stenosis. A 39-yr-old Korean male suffering from pulsatile tinnitus of the left ear was diagnosed to have dural arteriovenous malformation of the jugular bulb. Magnetic resonance imaging and angiography revealed a high-velocity vascular lesion encroaching the internal jugular vein and sigmoid sinuses. Digital subtraction angiography demonstrated a dural arteriovenous malformation involving the jugular bulb. The arterial supply was from the neuromeningeal branch of the left ascending pharyngeal artery and inferior tympanic artery. Stenosis of the left jugular vein caused retrograde venous drainage through the contralateral transverse sinus. Superselective embolization of these feeding arteries was successfully performed using 25% mixture of N-butylcyanoacrylate and lipiodol. In postembolization period, his complaints of pulsatile tinnitus and buzzing noise behind his left ear disappeared.     

旁正中穿质及其动脉的显微外科解剖

用手术显微镜观测了４８侧旁正中穿质及其动脉。旁正中穿质是界于乳头体、灰结节、视束与大脑脚之间的三角形区域，穿入此区的动脉为旁正中穿动脉和乳头体前动脉。乳头体前动脉的出现率９７．９２％，主要起自后交通动脉（９４．２３％），其余起自颈内动脉和大脑后动脉的交通后段。乳头体前动脉双支的出现率为１０．４２％。有８０．７７％的乳头体前动脉发支至视束、大脑脚和旁正中穿质。详细观察了穿旁正中穿质的动脉外径、长度及     

耳廓掀翻入路的显微解剖与临床应用

目的：报道耳外科新的手术入路的显微解剖与临床应用。方法：在38侧标本上对外耳血供进行解剖观察，设计了耳廓向下掀翻入路，应用于121例耳部疾患。结果：外耳血供来自颈外动脉的颞浅动脉和耳后动脉，其外侧面为颞浅动脉上、中、下耳支及耳后动脉耳廓支的穿支供应，背面为耳后动脉上、中、下耳支供应。经耳廓掀翻中耳乳突手术入路，手术野大，暴露好，未发生耳廓缺血坏死或感觉障碍。结论：耳廓掀翻是现代耳外科理想的手术进路。     

Arterial vascularization of the human thalamus: extra-parenchymal arterial groups

The problem of the arterial vascularization of the human thalamus has been debated at length. Anatomical references concerning the thalamic arterial groups are contradictory and complex, preventing any solid application in practice. It is, therefore, difficult to produce reliable anatomical radio-clinical correlation. In this work, 12 adult human cerebellums (24 hemispheres) were dissected after intra-vascular injection. With care for clarification and standardization, the extra-parenchymal thalamic arteries were classified in six groups: pre-mamillary artery, perforating thalamic arteries, thalamo-geniculate arteries, perforating branches of the postero-medial, postero-lateral and anterior choroidal arteries. Variations in the pre-mamillary artery were rare. The origin of the perforating thalamic artery was unilateral in two of three cases. The origin of the thalamo-geniculate arteries arose between the posterior cerebral artery (53%) and the posterior choroidal arteries (43%). The postero-median choroidal artery was most often single and usually gave the perforating branches for the medial aspect of the thalamus. The postero-lateral choroidal artery was frequently multiple and essentially gave the perforating branches for the superior aspect of the thalamus. The pulvinarian branches most often rose from the postero-lateral choroidal arteries (two thirds of cases) and more rarely from the postero-median choroidal arteries (one third of cases). The anterior choroidal artery is a source of thalamic vascularization by its cisternal branches running towards the lateral thalamus. It can also participate in the vascularization of the pulvinar by the plexiform branches crossing the temporal horn of the lateral ventricle. This study has allowed definition of the intra-parenchymatous arterial map of the thalamus. This mapping is essential for producing anatomical radio-clinical correlations which are pertinent for therapeutic decisions.

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Vascularisation artérielle du thalamus humain: groupes artériels extra-parenchymateux

Résumé La vascularisation artérielle du thalamus humain est un problème débattu de longue date. Les références anatomiques concernant les groupes artériels thalamiques sont contradictoires et complexes interdisant toute application concrète en pratique. Il est donc difficile de réaliser des corrélations anatomo-radio-cliniques fiables. Dans ce travail, nous avons disséqué 12 encéphales adultes humains (24 hémisphères) après injection intra-vasculaire. Avec un souci de clarification et de standardisation, nous avons classé les artères thalamiques extra-parenchymateuses en 6 groupes : artère pré-mamillaire, artères thalamo-perforantes, artères thalamo-géniculées, rameaux perforants des artères choroïdiennes postéro-médiale, postéro-latérale et antérieure. Les variations de l'artère pré-mamillaire sont rares. L'origine des artères thalamo-perforantes est unilatérale dans 2/3 des cas. La naissance des artères thalamo-géniculées se partage entre l'artère cérébrale postérieure (53%) et les artères choroïdiennes postérieures (43%). L'artère choroïdienne postéro-médiane est le plus souvent unique et donne préférentiellement des rameaux perforants pour la face médiale du thalamus. L'artère choroïdienne postéro-latérale est fréquemment multiple et donne essentiellement des rameaux perforants pour la face supérieure du thalamus. Les rameaux pulvinariens naissent le plus souvent des artères choroïdiennes postéro-latérales (dans 2/3 des cas) et plus rarement des artères choroïdiennes postéro-médianes (tiers des cas). L'artère choroïdienne antérieure est une source de vascularisation du thalamus par ses branches cisternales se dirigeant vers le thalamus latéral. Elle peut également participer à la vascularisation du pulvinar par des branches plexuelles traversant la corne temporale du ventricule latéral. La poursuite de ce travail doit permettre de préciser les cartographies artérielles intra-parenchymateuses du thalamus. Ces cartographies sont indispensables à la réalisation de corrélations anatomo-radio-cliniques pertinentes pour la prise de décision thérapeutique.