Anatomy of the superficial temporal artery and its branches: its importance for surgery

The temporoparietal, parieto-occipital flaps or the forehead flaps that are used in reconstructive surgery are prepared on the superficial temporal artery (STA) and its branches. For a successful surgery and a suitable flap design, adequate anatomical knowledge is needed. In our study, the red colored latex solution was injected into the external carotid artery; the STA and its branches were dissected in 27 specimens. The mean diameter of the STA at the zygomatic arch was determined as 2.73±0.51 mm. The diameters of the frontal branch were bigger than those of the parietal branch in 15 samples out of 27. The diameters of both the frontal and parietal branches were equal in four samples. The diameter of the parietal branch was bigger than that of the frontal branch in eight samples. In 20 samples out of 27 (74.07%), the bifurcation point of the STA was above the arch. In six samples (22.22%), the STA bifurcated directly over the arch. In only one sample (3.70%), bifurcation was not observed and the STA continued only as a frontal branch (absence of the parietal branch). The absence of the frontal branch was not encountered. In one sample (3.70%), double parietal branches were observed. In six samples out of 27 (22.22%), zygomatico-orbital artery was not encountered. In 21 samples (77.77%), zygomatico-orbital arteries ran towards the face, parallel to zygomatic arch and distributed in the orbicularis oculi muscle. The transverse facial artery existed in all samples. The auricular branches running to the helix and tragus were observed in all samples. The STA was 16.68±0.35 mm at the front of the tragus. Some landmarks were chosen on the head and then the STA was observed where it crossed all of these landmarks. This paper confirms the well-known variability of the superficial temporal arterial branches and their relation to the pericranial region. Knowledge concerning the arterial features of the lateral forehead region is important for the aesthetic surgeon. STA and its branches have been found to be suitable for use in microvascular anastomoses. A better understanding of the midline forehead vascularity should allow modification of reconstructive techniques and reduce postoperative complications.     

带颞浅血管颅骨瓣修复颌面部缺损的应用解剖

目的：为带颞浅血管蒂颅骨外板骨瓣转位修复颌面部缺损提供解剖学基础。方法：在30侧经动脉灌注乳胶的成人尸体标本和8头颈铸型标本（5例保留骨骼）上,对颞浅动脉的走行、分支及分布进行观测,并在标本上进行模拟术式设计。结果：颞浅动脉起自颈外动脉,于外耳门前方越过颧弓根部浅出至皮下,在皮下组织和颞浅筋膜之间向前上走行,至颧弓上方分为额、顶二终支,其分支营养颅顶部大至3/4区域的软组织、骨膜和颅骨外板,颞浅动脉主干及额支、顶支动脉外径均大于1mm,浅出部位至颞线处可游离长度为8cm以上。结论：设计以颞浅动脉为蒂颅骨外板骨瓣转位修复颌面部缺损具有可行性。     

成人大脑皮质老化形态学改变的MRI研究

目的 探讨成人大脑正常衰老过程中大脑皮质体积、厚度及表面积改变的区域性差异及侧化差异MRI的表现。方法 采用前瞻性研究。2017年9月—2018年1月山东省立医院影像科及寿光市人民医院CT磁共振室招募18~85岁右利手汉族健康成年志愿者109人,其中男性56人、女性53人,年龄(53.13±15.61)岁,均行3.0 T MRI颅脑扫描原始数据。使用FreeSurfer脑成像软件分析,获取左右大脑半球、各脑叶的感兴趣区脑皮质的体积、厚度及表面积的具体数值并进行标准化处理,分析其与年龄的相关关系,以及大脑皮质老化的区域性差异及侧化差异。结果 线性回归分析显示,大脑皮质体积、厚度及表面积随年龄增长而下降(P＜0.01),表现出与年龄相关的皮质体积减少较多的区域为海马旁回、额下回岛盖部、额中回、额下回三角部、舌回、颞中回(最大为-0.653%/岁,P＜0.01),皮质厚度减少较多的区域主要在颞上回、后扣带回、额中回、外眶额回、顶下缘角回、颞极、海马旁回(最大-0.009 mm/岁,P<0.01),皮质表面积减少较多的区域主要是在海马旁回、舌回、颞下回、额中回、额下回岛盖部(最大-0.402%/岁,P＜ 0.01)。大脑左右半球皮质体积年龄效应不对称的区域为额上回、额下回岛盖部及三角部、中眶额回、额极、顶下缘角回、缘上回、梭状回、颞极、海马旁回、前扣带回、内嗅皮层(P＜0.05),皮质厚度年龄效应不对称的区域为额上回、额下回岛盖部、中眶额回、楔叶、颞下回、颞极、前扣带回、后扣带回(P＜0.05),皮质表面积年龄效应不对称的区域为额上回、额中回、额下回岛盖部及三角部、中眶额回、额极、顶下缘角回、缘上回、梭状回、颞极、海马旁回、前扣带回、后扣带回、内嗅皮层(P＜0.05)。结论 在人脑的正常老化过程中,大脑皮质体积、厚度及表面积与年龄呈现线性负相关性改变,不同脑区皮质与年龄呈不同程度的线性负相关关系,部分脑回皮质的年龄效应存在侧化差异,皮质体积、厚度、表面积三个形态学指标是相互关联的。     

颞浅动脉额支皮瓣的应用解剖学

目的：为带蒂颞浅动脉额支皮瓣转移修复眼部软组织缺损提供解剖学资料。方法：对头面部乳胶灌注的标本进行解剖，并对颞浅动脉的走行、分支、分布进行观测。结果：颞浅动脉起自颈外动脉，穿腮腺实质上行，在颧弓上方分为额、顶两终末支。额支又于外毗上方分为额顶支和额眶支。额支、额顶支、额眶支血管外径均在1mm左右，可游离血管长度符合要求。结论：以颞浅动脉额支为蒂的皮瓣可用来转位修复眶周软组织缺损。     

Neural sources involved in auditory target detection and novelty processing: an event-related fMRI study

We used event-related functional magnetic resonance imaging (erfMRI) techniques to examine the cerebral sites involved with target detection and novelty processing of auditory stimuli. Consistent with the results from a recent erfMRI study in the visual modality, target processing was associated with activation bilaterally in the anterior superior temporal gyrus, inferior and middle frontal gyrus, inferior and superior parietal lobules, anterior and posterior cingulate, thalamus, caudate, and the amygdala/hippocampal complex. Analyses of the novel stimuli revealed activation bilaterally in the inferior frontal gyrus, insula, inferior parietal lobule, and in the inferior, middle, and superior temporal gyri. These data suggest that the scalp recorded event-related potentials (e.g., N2 and P3) elicited during similar tasks reflect an ensemble of neural generators located in spatially remote cortical areas.     

The supra-auricular arterial network: anatomical bases for the use of superior pedicle retro-auricular skin flaps

The authors present an anatomical study on vascularization of the retro-auricular skin, focusing on the origin, distribution and anastomoses of the superior auricular artery. This artery is used as the pedicle of a retro-auricular flap to repair defects in the upper third of the auricle and in the temporal region. The study was carried out on 13 fresh cadavers, with a total of 25 auricles. The common carotid artery had previously been injected with dyed latex. The superior auricular artery was found in all specimens. It had constant course and caliber, mean axial length 2.4 cm, mean caliber 0.8 mm. This artery connected the superficial temporal artery, or its parietal branch, and the posterior auricular artery network. This branch proved a reliable vascular pedicle for the mobilization of retro-auricular flaps. The results of this study are presented together with preliminary clinical results obtained using an antero-superior retro-auricular flap, never previously described, to reconstruct the superior third of the auricle and the temporal region.     

静息态脑功能技术对平衡针治疗中枢机制的分析应用

背景：平衡针治疗疾病疗效显著,但缺乏相关现代科学理论机制。 目的：利用静息态脑功能成像技术探讨平衡针疗法的中枢作用机制。 方法：纳入10例腰椎间盘突出腰腿痛患者及10例正常受试者,于平衡针针刺前后进行功能磁共振扫描,通过AFNI软件对与双侧杏仁核表现为显著联系的脑区进行功能连接分析,并对平衡针刺后腰椎间盘突出患者及正常受试者的脑功能连接的差异进行探讨。 结果与结论：经平衡针治疗后10例腰椎间盘突出患者疼痛均有好转。脑功能连接分析显示腰椎间盘突出患者丘脑、脑干、腹前核、腹外侧核、额内侧回、额上回、额叶眶上回、额下回、颞上回、颞中回、海马回、扣带回、岛叶等脑区功能连接增强。正常受试者双侧颞中回、双侧眶上回、双侧尾状核头、双侧岛叶、左侧腹背侧核、双侧额上回、左侧额中回、前扣带回、右侧顶下小叶与杏仁核连接增强;双侧小脑齿状核、小脑蚓、左侧小脑坡、双侧舌回、左侧枕中回、右侧额上回、右侧中央前回、双侧顶下小叶、右侧顶上小叶、右侧中央后回与杏仁核连接下降。提示通过静息脑功能成像技术对杏仁核的研究有助于更深入理解平衡针灸治疗腰腿痛的中枢机制。     

颞浅动脉额支的观测及其临床意义

目的为颞动脉活检提供颞浅动脉额支相关的解剖学资料。方法对16具防腐成人尸体标本进行解剖,对颞浅动脉额支进行相关的解剖学观测、测量。结果①颞浅动脉额支在起点和末梢分叉点之间的长度为(45.93±7.29)mm;②颞浅动脉额支在起点和末梢分叉点的坐标值分别为(22.95±3.81,17.32±4.54)mm和(59.93±8.94,37.48±5.37)mm;③颞浅动脉额支在起点和末梢分叉点之间直线相关,直线回归方程为y赞=7.06+0.50X,相关系数r=0.68,P<0.001。结论深入了解颞浅动脉额支的解剖学特点及其与周围结构的解剖学关系,有利于颞动脉活检中颞浅动脉额支的定位及防止周围结构的损伤。     

Further observations on parieto-temporal connections in the rhesus monkey

Summary The origin, course, and termination of parieto-temporal connections in the rhesus monkey were studied by autoradiographic techniques. The caudal third of the inferior parietal lobule (including the adjacent lower bank of the intraparietal sulcus) is the chief source of these projections. It projects to three separate architectonic areas in the superior temporal sulcus and to three different areas on the ventral surface of the temporal lobe: the parahippocampal gyrus, presubiculum, and perirhinal cortex. The mid-inferior parietal lobule and medial surface of the parietal lobe, by contrast, project only to the caudal upper bank of the superior temporal sulcus. The rostral inferior parietal lobule and the superior parietal lobule, as well as the postcentral gyrus and rostral parietal operculum, do not project to the temporal lobe. Fibers travel from the posterior parietal region to temporal cortex by way of several different routes. One fiber bundle courses in the superior temporal gyrus and terminates in the superior temporal sulcus. Another proceeds ventrally, between the depth of the superior temporal sulcus and the geniculocalcarine tract, to the parahippocampal area. A separate bundle, coursing part of the way in the company of the cingulum bundle, conveys posterior parietal fibers to the presubiculum.Preliminary results of this investigation were presented at the meeting of the American Association of Anatomists, Atlanta, Georgia, April 1983     

男性攻击性精神分裂症患者杏仁核功能连接的磁共振研究

目的:探讨男性攻击性精神分裂症患者是否存在杏仁核与其他脑区功能连接的异常.方法:对有攻击行为和没有攻击行为的男性精神分裂症患者各13例进行静息状态下功能磁共振成像.结果:与非攻击组相比,攻击组双侧额中回、右侧额上回、右侧脑岛、右侧顶上小叶、右侧扣带回等脑区与左侧杏仁核功能连接增强;双侧额上回、额中回、双侧颞上回、右侧颢中回等脑区与右侧杏仁核功能增强.结论:杏仁核与多个脑区之间特别是与额上回、额中回的功能连接增强可能与男性精神分裂症患者的攻击行为有关.     

遭受多重侵害高职高专女生静息态脑功能局部一致性的研究

目的:探讨遭受多重侵害的高职高专女生静息态脑功能磁共振特点。方法:15名遭受多重侵害无创伤后应激症状被试(PV无PTSS组)、15名多重侵害有创伤后应激症状被试(PV有PTSS组)和15名正常对照接受静息态脑功能扫描。采用SPM8和静息态功能磁共振数据处理工具包分别进行数据预处理和ReHo分析。结果:静息状态下,与对照组相比,PV无PTSS组左侧额下回、左右额内侧回、右侧中央后回、左侧梭状回、左右海马旁回、右侧扣带回、左右豆状核和右侧岛叶的ReHo值降低;左右额上回、左右额中回、左右额下回、左右顶下小叶、左右楔前叶、左右颞上回、左侧颞横回、左右颞中回、右侧舌回和右侧扣带后回的ReHo值升高。与PV有PTSS组相比,PV无PTSS组在右侧额中回和额下回、左侧楔前叶、左侧舌回、左右海马旁回、左侧扣带回和左侧豆状核ReHo值降低;在左右额上回、左右额中回、左侧额内侧回、右侧中央后回、左侧缘上回、左右顶下小叶、左侧梭状回和左侧尾状核ReHo值升高。结论:遭受多重侵害但无创伤后应激症状的高职高专女生在静息状态下脑默认网络以及岛叶、基底神经节、海马旁回存在局部一致性信号异常,这些脑区异常可能为遭受多重侵害导致精神障碍的发病机制提供重要线索。     

The superficial temporal artery: anatomical type and clinical application to the flap of the fascia temporal superficialis

The goal of our study is to assess the anatomical type of the superficial temporal artery (STA) in the black population using the classification of Ricbourg et al.. Forty-seven fresh cadavers and three extracted and frozen heads were included in this study. The external carotid artery was isolated in the neck and injected by Rhodopas stained with Congo Red. The superficial temporal artery was dissected using a Y-shaped skin incision. The last step of the procedure was to remove the flap of the fascia superficialis temporis. The third segment of the superficial temporal artery and its terminal branches were studied. This segment courses cephalad and wraps the zygomatic arcade. It splits into two terminal branches: the temporo-frontal and the temporo-parietal ones. The most important of its collaterals, the zygomato-maleus artery, plays a crucial role for distinguishing the subtypes of STA according to the classification of Ricbourg et al.. Indeed, this branch can be subdivided into two types: --type I: the zygomato-malar artery arises from the trunk of the STA; it courses perpendicular and with a slightly ascending direction; this type accounts for 93% of the cases. --type II: the zygomato-malar artery originates from the branch of the temporo-frontal artery. Its course is either horizontal or caudad. This type accounts for 3% of the cases. Our results confirm those of Ricbourg et al.. Thus, we could not CONFIRM the notion of a racial predominance of typology of the STA in our context. We did not study the dimensions of STA and also the level of its bifurcation. Indeed, it has been largely reported in the literature. These elements constitute the anatomic basis of the surgical use of temporal flaps. The vessel-containing tissue in which travels the STA forms the so-called fascia temporalis superficialis whose plasticity and polyvalency are critical during the procedures of plastic and reconstructive surgeries.     

Analysis of the subcomponents and cortical terminations of the perisylvian superior longitudinal fasciculus: a fiber dissection and DTI tractography study

The anatomy of the perisylvian component of the superior longitudinal fasciculus (SLF) has recently been reviewed by numerous diffusion tensor imaging tractography (DTI) studies. However, little is known about the exact cortical terminations of this tract. The aim of the present work is to isolate the different subcomponents of this tract with fiber dissection and DTI tractography, and to identify the exact cortical connections. Twelve postmortem human hemispheres (6 right and 6 left) were dissected using the cortex-sparing fiber dissection. In addition, three healthy brains were analyzed using DTI-based tractography software. The different components of the perisylvian SLF were isolated and the fibers were followed until the cortical terminations. Three segments of the perisylvian SLF were identified: (1) anterior segment, connecting the supramarginal gyrus and superior temporal gyrus with the precentral gyrus, (2) posterior segment, connecting the posterior portion of the middle temporal gyrus with the angular gyrus, and (3) long segment of the arcuate fasciculus that connects the middle and inferior temporal gyri with the precentral gyrus and posterior portion of the inferior and middle frontal gyri. In the present study, three different components of the perisylvian SLF were identified. For the first time, our dissections revealed that each component was connected to a specific cortical area within the frontal, parietal and temporal lobes. By accurately depicting not only the trajectory but also cortical connections of this bundle, it is possible to develop new insights into the putative functional role of this tract.     

Emerging patterns of the human superior thyroid artery and review of its clinical anatomy

Purpose

There is wide variability of the location of the superior thyroid artery (STA). Our purpose was to describe variations of the STA origin, with great respect to different anatomical patterns which could be observed in humans.

Methods

The material was 68 formalin-embalmed adult cadavers of both sexes (45–70-year-old). Methodologically, we dissected the neck region bilaterally and focused on studying the external carotid artery (ECA) branches, especially the STA emerging pattern. We also measured the distance of the STA origin from the common carotid artery (CCA) bifurcation (using the latter as a landmark).

Results

Based on our results we categorized the STA emerging pattern into three major types A, B and C according to its origin (which was CCA, ECA and CCA bifurcation, respectively). Regarding type B, we found that the left STA arises approximately 2 mm closer to the CCA bifurcation compared to the right STA (p < 0.05).

Conclusions

The STA is a carotid branch with variable origin, which can be CCA, ECA or CCA bifurcation. It is also an artery of great clinical importance in head and neck surgery. The present study provided data of the STA emerging patterns, as well as a review of its clinical anatomy.     

Is a neutral expression also a neutral stimulus? A study with functional magnetic resonance

Although neutral faces do not initially convey an explicit emotional message, it has been found that individuals tend to assign them an affective content. Moreover, previous research has shown that affective judgments are mediated by the task they have to perform. Using functional magnetic resonance imaging in 21 healthy participants, we focus this study on the cerebral activity patterns triggered by neutral and emotional faces in two different tasks (social or gender judgments). Results obtained, using conjunction analyses, indicated that viewing both emotional and neutral faces evokes activity in several similar brain areas indicating a common neural substrate. Moreover, neutral faces specifically elicit activation of cerebellum, frontal and temporal areas, while emotional faces involve the cuneus, anterior cingulated gyrus, medial orbitofrontal cortex, posterior superior temporal gyrus, precentral/postcentral gyrus and insula. The task selected was also found to influence brain activity, in that the social task recruited frontal areas while the gender task involved the posterior cingulated, inferior parietal lobule and middle temporal gyrus to a greater extent. Specifically, in the social task viewing neutral faces was associated with longer reaction times and increased activity of left dorsolateral frontal cortex compared with viewing facial expressions of emotions. In contrast, in the same task emotional expressions distinctively activated the left amygdale. The results are discussed taking into consideration the fact that, like other facial expressions, neutral expressions are usually assigned some emotional significance. However, neutral faces evoke a greater activation of circuits probably involved in more elaborate cognitive processing.     

Bilateral comparison of the vascular pattern of the superficial temporal artery based on digital subtraction angiography

Purpose

This study was performed to investigate any bilateral differences in the vascular pattern and microsurgical relevant parameters of the superficial temporal artery (STA) in vivo.

Methods

Digital subtraction angiographies of the STA of 38 individuals were retrospectively analyzed. A bilateral comparison of the branching pattern as well as of surgically relevant diameters and lengths of the main branches of the STA was performed. Moreover, gender-specific differences were assessed.

Results

Only 10 cases (26 %) demonstrated an identical type and subtype of the STA pattern bilaterally. The diameters of the STA at its origin and bifurcation level as well as of its parietal branch were statistically significant wider on the right than on the left side (p _o  = 0.0009, p _b  = 0.006, p _p  = 0.030). Moreover, the diameters of the STA at its origin level on the right side, at its bifurcation level on both sides and of the frontal branch on both sides were statistically significant wider in males than females. No statistically significant differences of the lengths of the STA and its main branches between the right and the left side were identified.

Conclusion

The occurrence of the vascular pattern of the STA in vivo is random for each side of the same person and cannot be predicted by the vascular pattern of the opposite side. The calibers of the main branches of the STA are gender specific and commonly larger on the right than on the left side.

     

糖尿病视网膜病变患者自发活动性异常的脑区与MoCA的相关性研究

目的 基于静息态功能磁共振局部一致性技术探讨糖尿病视网膜病变患者局部脑区一致性的改变及与认知关系.方法 选择27例糖尿病视网膜病变(DR)及与之年龄、性别、受教育年限相匹配的单纯糖尿病(N-DR)患者27例,均进行实验室检查、蒙特利尔量表(MoCA)检测及头颅磁共振扫描.利用多元回归分析及Pearson回归分析观察临床变量与活动性异常活动脑区ReHo值之间的关系.结果 相对于N-DR,DR患者在左小脑后叶、右额叶/额中回/内侧回、右枕叶/楔叶/距状回、左颞叶/上/中回、右边缘叶/后扣带回、左顶叶/中央后回ReHo值降低;在左额叶/眶部额上回、左顶叶/楔前叶ReHo值增强.而且MoCA量表评分与颞叶及楔前叶异常活动的脑区存在相关性.降低的枕叶距状回及颞叶中回与糖化血红蛋白呈负相关,增强的眶额叶与糖化血红蛋白呈正相关.结论 糖尿病视网膜病变患者存在多个脑区活动性异常的表现,且这些局部异常活动的脑区与认知功能及糖化血红蛋白存在相关.     

Acupoint-specific fMRI patterns in human brain

Specific central nervous system (CNS) responses to acupuncture have recently attracted attention. It is important to understand the differences in fMRI images of the brain evoked by acupuncture at an acupoint and at a nearby "sham" point. Here, we report analyses of fMRI images of the brains of 37 healthy volunteers in response to acupuncture at Liv3 (Taichong) and LI4 (Hegu) versus their sham points. We found common activation areas in response to Liv3 or LI4 acupuncture in the middle temporal gyrus and cerebellum, along with deactivation areas in the middle frontal gyrus and inferior parietal lobule, compared with the effects of acupuncture at sham points. Acupuncture at Liv3 evoked specific activation at the postcentral gyrus, posterior cingulate, parahippocampal gyrus, BA 7, 19 and 41, but deactivation at the inferior frontal gyrus, anterior cingulate, BA 17 and 18, compared with acupuncture at its sham point. Acupuncture at LI4 evoked specific activation at the temporal pole, but deactivation at the precentral gyrus, superior temporal gyrus, pulvinar and BA 8, 9 and 45, compared with acupuncture at its sham point. These observations reveal that acupuncture at acupoints induces specific patterns of brain activity, and these patterns may relate to the therapeutic effects of acupuncture.     

Multisensory cortical signal increases and decreases during vestibular galvanic stimulation (fMRI)

Functional magnetic resonance imaging blood-oxygenation-level-dependent (BOLD) signal increases (activations) and BOLD signal decreases ("deactivations") were compared in six healthy volunteers during galvanic vestibular (mastoid) and galvanic cutaneous (neck) stimulation in order to differentiate vestibular from ocular motor and nociceptive functions. By calculating the contrast for vestibular activation minus cutaneous activation for the group, we found activations in the anterior parts of the insula, the paramedian and dorsolateral thalamus, the putamen, the inferior parietal lobule [Brodmann area (BA) 40], the precentral gyrus (frontal eye field, BA 6), the middle frontal gyrus (prefrontal cortex, BA 46/9), the middle temporal gyrus (BA 37), the superior temporal gyrus (BA 22), and the anterior cingulate gyrus (BA 32) as well as in both cerebellar hemispheres. These activations can be attributed to multisensory vestibular and ocular motor functions. Single-subject analysis in addition showed distinctly nonoverlapping activations in the posterior insula, which corresponds to the parieto-insular vestibular cortex in the monkey. During vestibular stimulation, there was also a significant signal decrease in the visual cortex (BA 18, 19), which spared BA 17. A different "deactivation" was found during cutaneous stimulation; it included upper parieto-occipital areas in the middle temporal and occipital gyri (BA 19/39/18). Under both stimulation conditions, there were signal decreases in the somatosensory cortex (BA 2/3/4). Stimulus-dependent, inhibitory vestibular-visual, and nociceptive-somatosensory interactions may be functionally significant for processing perception and sensorimotor control.     

Negative BOLD during tongue movement: A functional magnetic resonance imaging study

The aim of this functional magnetic resonance imaging (fMRI) study was to evaluate negative blood oxygen level-dependent (BOLD) signals during voluntary tongue movement. Deactivated (Negative BOLD) regions included the posterior parietal cortex (PPC), precuneus, and middle temporal gyrus. Activated (Positive BOLD) regions included the primary somatosensory-motor area (SMI), inferior parietal lobule, medial frontal gyrus, superior temporal gyrus, insula, lentiform nucleus, and thalamus. The results were not consistent with previous studies involving unilateral hand and finger movements showing the deactivation of motor-related cortical areas including the ipsilateral MI. The areas of Negative BOLD in the PPC and precuneus might reflect specific neural networks relating to voluntary tongue movement.