Gross and scanning electron microscopy of the carotid rete--cavernous sinus complex of the sheep (Ovis aries)

Intravascularly plastic injected specimens of the carotid rete of the sheep were investigated. In addition, glutaraldehyde-fixed, freeze-fractured and sputter-coated retia were examined by SEM. The carotid rete is supplied by one caudal and 2-4 rostral rete branches of the maxillary artery, with a few variations in the origin of the rostral rete branches. The tunica adventitia of muscular arteries was continuous with that of the cavernous sinus. The endothelial cells of the cavernous sinus were differently oriented than those of the arterial rete branches. In addition, craters were found in the endothelial cells of the arteries but not in those of the cavernous sinus.     

内镜下扩大经鼻入路海绵窦区解剖学观察

目的通过内镜下扩大经鼻入路海绵窦解剖研究,进一步明确海绵窦内神经血管关系,为海绵窦区疾病的临床治疗提供解剖学依据。方法在8具成人尸头(共16侧海绵窦)上应用0度和30度柱状硬性内窥镜,模拟扩大经鼻入路进行海绵窦区解剖研究。结果内镜下扩大经鼻入路可清楚的显露海绵窦内结构;相关解剖标志有利于解剖定位。结论神经内镜下扩大经鼻入路是海绵窦区解剖及手术的最佳入路。     

彩超及多排CT在诊断颈动脉海绵窦瘘中的应用

目的探讨B超及多排螺旋CT血管造影(CTA)在诊断颈动脉海绵窦瘘中的应用价值。方法分析23例颈动脉海绵窦瘘病例。对受检者行B型超声及颅脑CTA检查,采用容积再现(VR)、最大密度投影(MIP)、多平面重建(MPR)技术处理图像。结果超声可发现增粗的眼上静脉与脉搏同步搏动,并能检测血流频谱,CT检查发现23例均海绵窦扩大.动脉期眼上静脉显影并扩张,8例动脉期大脑中静脉显影并扩张。其中一例同时合并左侧大脑中动脉动脉瘤。结论B型超声及多排螺旋CT血管造影对诊断颈内动脉海绵窦瘘有重要的应用价值。     

Innervation of the cavernous body of the human efferent tear ducts and function in tear outflow mechanism

The lacrimal sac and nasolacrimal duct are surrounded by a wide cavernous system of veins and arteries comparable to a cavernous body. The present study aimed to demonstrate the ultrastructure of the nervous tissue and the localisation of neuropeptides involved in the innervation of the cavernous body, a topic not previously investigated. Different S‐100 protein antisera, neuronal markers (neuron‐specific enolase, anti‐200 kDa neurofilament), neuropeptides (substance P, neuropeptide Y, calcitonin gene‐related peptide, vasoactive intestinal polypeptide) and the neuronal enzyme tyrosine hydroxylase were used to demonstrate the distribution pattern of the nervous tissue. The ultrastructure of the innervating nerve fibres was also examined by means of standard transmission electron microscopy. The cavernous body contained specialised arteries and veins known as barrier arteries, capacitance veins, and throttle veins. Perivascularly, the tissue was rich in myelinated and unmyelinated nerve fibres in a plexus‐like network. Small seromucous glands found in the region of the fundus of the lacrimal sac were contacted by nerve fibres forming a plexus around their alveoli. Many nerve fibres were positive for S‐100 protein (S 100), neuron‐specific enolase (NSE), anti‐200 kDa neurofilament (RT 97), calcitonin gene‐related peptide (CGRP), substance P (SP), tyrosine hydroxylase (TH), and neuropeptide Y (NPY). Vasoactive intestinal polypeptide (VIP) immunoreactivity was only demonstrated adjacent to the seromucous glands. Both the density of nerve fibres as well as the presence of various neuropeptides emphasises the neural control of the cavernous body of the human efferent tear ducts. By means of this innervation, the specialised blood vessels permit regulation of blood flow by opening and closing the lumen of the lacrimal passage as effected by the engorgement and subsidence of the cavernous body, at the same time regulating tear outflow. Related functions such as a role in the occurrence of epiphora related to emotional responses are relevant. Moreover, malfunction in the innervation of the cavernous body may lead to disturbances in the tear outflow cycle, ocular congestion or total occlusion of the lacrimal passages.     

体表海绵状静脉畸形病理结构观察及意义

目的 观察体表海绵状静脉畸形的病理结构，探讨其畸形的病理机制。方法 体表海绵状静脉畸形42例，正常中型静脉、小静脉各12例，HE染色观察病理结构，测量海绵状静脉畸形、中小静脉的血窦(管)半径、血窦(管)壁厚度，计算血窦(管)半径与血窦(管)壁厚度的比值。结果 海绵状静脉畸形的血窦壁很薄、平滑肌细胞少，血窦半径与血窦壁厚度的比例明显大于正常中小静脉；海绵状静脉畸形的病理结构可分为蜂窝型、沟渠型和混合型3种类型。结论 体表海绵状静脉畸形血窦的发育过程中存在血管塑型障碍，血窦壁张力减低，这是畸形发病的主要原因之一。     

海绵窦内外侧膜交接处的显微解剖

目的：寻找进入海绵窦的新方法。方法：对8例成人头颅海绵窦(共16侧)结构进行显微解剖研究。结果：颅底硬脑膜有两层，内层在海绵窦内外侧膜交接处与外层分离，与眼神经等包膜融合，并同海绵窦外侧膜的内外两层形成外侧膜潜在间隙，自颅中窝撕开内外侧膜交接处的颅底硬脑膜内层后，通过该潜在间隙可直接进入海绵窦。结论：经外侧膜潜在间隙可进入海绵窦。     

An electron microscopic study of the cavernous bodies in the lamprey gill filaments

The cavernous body in the lamprey gill filament was studied by electron microscopy. This body lies along the outer border of the axial plate of each gill filament and freely communicates with an afferent filament artery. Two series of blood channels run alternately, passing through the cavernous body, and lead to the marginal channels in the secondary lamellae. On the other hand, narrow blood spaces left in the cavernous body lead to the blood lacunae in the axial plate (osmoregulatory region) and to those in the secondary lamellae (respiratory region). All the blood in the cavernous body is finally collected by an efferent filament artery. The cavernous body is traversed by numerous trabeculae and collagenous columns which run diagonally in the blood spaces to connect the walls of the cavernous body. All the walls of the cavernous body, including trabeculae and collagenous columns, are completely surrounded by the cytoplasmic flanges of specialized cells called here “cavernous body cells.” These cells are about 30 μm in diameter and characterized by (1) association with collagenous columns or trabeculae and also by the presence of (2) coated caveolae and vesicles, (3) vacuoles and (4) cytoplasmic granules in their cytoplasm. These cells are considered to be related to the pillar cells in origin because of their close association with collagenous columns or trabeculae. The functional significance of the cavernous body and the cavernous body cells is discussed.     

经颅海绵窦手术的显微外科解剖及临床应用

目的：研究额颞眶-颧弓入路中,海绵窦的不同切开方法对其显微结构的显露,为海绵窦病变的直接手术提供安全手术入路。方法：10例成人头颅标本,采用经额颞眶-颧弓开颅,在显微镜下对海绵窦的侧方硬膜外,侧方硬膜下,及上方入路进行解剖学观察。并对16例海绵窦病变手术治疗的临床资料进行分析。结果：外侧硬膜外入路可用于显露三叉神经第2、3支,三叉神经节,海绵窦内颈内动脉后垂直段,外展神经及岩骨颈内动脉水平段;侧方硬膜下入路可用于显露海绵窦外侧前下,后上静脉间隙,以及所有走行在海绵窦内的颅神经和海绵窦内颈内动脉水平段;上方入路可用于显露海绵窦内侧、外侧及后上间隙,海绵窦内ICA水平段、前膝、前垂直段及床突段的内侧面,以及垂体的外侧面。结论：依据海绵窦内病变的位置不同,在额颞眶--颧弓入路中采用不同的手术方法切开海绵窦,既可安全地显露病变,又可保护重要的神经和血管。     

Revisit the Cavernous Sinus from Fetus to Adult—New and Old Data

This article highlighted three advances in the study of the cavernous sinus: (1) the initial formation of the sinus reticulum in early development of the sphenoid bone before ossification (2) extension of reticulum of the sinus and connection with other venules, and (3) the cavernous sinus and the nerves evolved inside this sinus during gestation, for example, the trigeminal nerve already formed bundles of motor and parasympathetic components during fetal development. This ontogenetic study further confirmed the cavernous sinus is not a single or a dual set of sinuses, but a group of extensions of venous sinuses or sinusoids. These new insights were integrated with previous understandings of the cavernous sinus to form this review article. Anat Rec, 301:819–824, 2018. © 2017 Wiley Periodicals, Inc.     

人阴茎海绵体微血管构筑的研究

目的：阐明人阴茎海绵体微血管构筑及其生理意义。方法：阴茎血管铸型扫描电子显微镜下观察。结果：阴茎海绵体内纵行的动脉发出无数树状分支,其中部分分支为毛细血管,此毛细血管汇合后注入白膜下静脉丛;部分形成螺旋动脉,与海绵窦相交通。在阴茎海绵体表面,环动脉的分支亦部分与海绵窦相通,部分分为毛细血管。引流海绵窦血液的窦后小静脉相互吻合形成白膜下静脉丛,白膜下静脉丛汇合后形成导静脉。结论：①在阴茎海绵体内有营养性的毛细血管系统和功能性的螺旋动脉系统;②在阴茎海绵体表面存在白膜下静脉丛。     

Cavernous haemangioma in the interpeduncular cistern: case report and review of literature

A rare case of a cavernous haemangioma in the interpeduncular cistern is reported. The patient, forty-five year old male presented with excruciating left sided trigeminal neuralgia and diplopia for the past one year. Examination revealed left third and fifth nerve paresis. Magnetic resonance imaging showed a well-defined, lobulated tumour in the interpeduncular cistern. The tumour was totally excised through a subtemporal route. Histology of the tumour revealed a cavernous haemangioma. Extracerebral location for a cavernous haemangioma is rare. An interpeduncular cavernous haemangioma has never been reported earlier in literature. The clinical and radiological features are discussed and relevant literature is briefly reviewed.     

Development of substance P immunoreactivity in the mouse vomeronasal organ

We investigated the development of substance P immunoreactivity in mouse vomeronasal organs in embryos, juveniles, and adults. In all stages, substance P fibers were found in the receptor-free epithelial area, but never in the neuroepithelium. Substance P fibers were found sparsely in the lamina propria of 15-day-old embryos. Although buds of the vomeronasal glands in the cavernous tissue were observed in 17-day-old embryos, and gradually grew in size and numbers, the substance P fibers around them decreased after about the 13th day. Thus, substance P may be a trophic factor for the development of the vomeronasal glands in the cavernous tissue. We first recognized substance P fibers reaching the surface of the receptor-free epithelium in 13-day-old pups. In 21-day-old mice, substance P fibers were as well developed as in adult mice. Considering the development of the substance P fibers in the receptor-free epithelium and the cavernous tissue, they probably cause the vasodilation of the cavernous tissue via local axon reflexes. These structures may then act as a defense system, eliminating noxious stimulus substances sucked into the vomeronasal organ.     

海绵窦区三角解剖及面积的临床应用

目的　观察海绵窦区各脑神经相互关系及其变异,测量各海绵窦三角的面积,为临床经海绵窦显微外科手术提供解剖学依据。 方法　对12例成人尸头标本的海绵窦区域进行显微解剖和观测,并对海绵窦各三角的面积进行测算。 结果　在海绵窦区的三角中,分别选取、观测床突三角、动眼神经三角、滑车上三角、滑车下三角、前内侧三角、前外侧三角、后内侧三角、后外侧三角并分别测量其面积为77.75、82.73、45.00、83.40、66.38、51.28、121.65、161.67 mm2。 结论　海绵窦区三角是神经外科颅底手术入路必经区域,是手术中可参考的操作范围,因部分神经、骨性结构变异,可导致部分三角面积缩小而影响手术操作。测量各三角面积的数据,在临床工作实践中,可作为手术入路选择的参考,并为虚拟现实技术实践提供数据支持。     

肝海绵状血管瘤临床特点及病理分析

目的 探讨肝海绵状血管瘤的临床病理特征。方法 收集2014年1月~2017年4月我院存档的25例肝海绵状血管瘤石蜡标本,行HE染色后观察其病理形态,并结合患者病史和影像学资料总结肝海绵状血管瘤的临床病理特征。结果 共25例肝海绵状血管瘤标本,其中女性18例,男性7例;病灶位于左肝叶10例,右肝叶12例,左、右肝叶均有者3例,分布无明显规律;血管瘤单发20例,多发5例;病灶最大径4~10 cm。CT平扫表现为肝实质内圆形、类圆形或不规则形低密度影,边缘尚清楚;动脉期呈结节状强化;门静脉期强化向心性强化;平衡期和延迟期肿瘤持续向心性强化,且强化程度减低。MRI表现为T1WI呈均匀低信号,T2WI呈均匀高信号,病灶边缘清晰。肝海绵状血管瘤表现为质地柔软的肿物,切面无包膜,呈腔隙状;病变与周围肝组织分界清楚,由大量不规则形扩张的血管组成,管腔大小、形状不一。结论 肝海绵状血管瘤临床表现不明显,以女性多见,单发为主;病变主要由大小不等的异常血管腔组成,管腔内衬单层扁平内皮细胞,周围环绕纤维组织。     

The influence of the nasal mucosa and the carotid rete upon hypothalamic temperature in sheep

1. In chronically-prepared sheep, intracranial temperatures were measured in the cavernous sinus among the vessels of the carotid rete and at the circle of Willis extravascularly, and in the preoptic area and in other brain stem regions. Extracranial temperatures were measured intravascularly in the carotid or internal maxillary arteries and on the nasal mucosa and the skin of the ear.2. At 20 degrees C ambient temperature, shifts in temperature of the hypothalamus and of other brain sites paralleled temperature shifts in the cerebral arterial blood which was cooler than central arterial blood. During periods of arousal and of paradoxical sleep, vasoconstriction of the nasal mucosa and the ear skin occurred and temperatures at the cerebral arteries and in the brain rose without a comparable rise in central arterial blood temperature.3. Anaesthetic doses of barbiturate abolished the temperature oscillations in the cerebral arterial blood and the brain. When air was blown rapidly over the nasal mucosa in anaesthetized animals, temperatures dropped precipitously in the cavernous sinus, at the cerebral arteries, and in the brain, while central arterial temperature fell only slightly. Injections of latex into the facial venous system demonstrated a venous pathway from the nasal mucosa to the cavernous sinus.4. When sheep were exposed to 45-50 degrees C ambient temperature, respiratory rate increased 5-10 times and the temperature gradient between central and cerebral arterial blood widened.5. It is concluded that venous blood returning from the nasal mucosa and the skin of the head to the cavernous sinus cools the central arterial blood in the carotid rete. This is an important factor in the maintenance of hypothalamic temperature in the wool-covered, long-nosed, panting sheep and undoubtedly affects hypothalamic thermoreceptors and temperature regulation in artiodactyls.     

Anatomical variations of the ten triangles around the cavernous sinus

The dimensions of the 10 triangles around the cavernous sinus were measured to define the anatomical characteristics of the triangles and to compare their consistency in shape and area. Twelve tissue blocks containing the bilateral cavernous sinuses and medial two-thirds of the middle cranial fossae were obtained from Japanese adults at autopsy, fixed to a stereotactic frame, and examined with an operative microscope. The dimensions of each triangle were measured with calipers and compared, based on the same point and border. The anteromedial triangle and the superolateral (Parkinson's) triangle were more consistent in shape than the paramedial and oculomotor triangles, but the oculomotor triangle was larger in area than these other triangles. The posteromedial (Kawase's) triangle was more consistent in shape and larger than the anterolateral, lateral, and the posterolateral (Glasscock's) triangles. The anteromedial and superolateral (Parkinson's) triangles are important for the combined epi- and subdural approach to cavernous sinus lesions. The posteromedial (Kawase's) triangle is important for gaining access to the posterior cranial fossa from the middle cranial fossa.     

经颅底硬膜外切除海绵窦肿瘤12例

目的：探讨经颅底硬膜外切除海绵窦肿瘤的可能性及实用性。方法：应用最新的海绵窦解剖理论，对12例侵入海绵窦的颅中窝肿瘤进行手术治疗，经硬膜外切除窦内肿瘤。结果：经颅中窝硬膜外可以进入海绵窦，全切肿瘤8例，次全切4例。4例窦内结构保全良好。结论：侵入海绵窦的颅内外沟通性肿瘤可经颅底硬脑膜外入路全切除。     

Physiological importance of the conjugation of the internal carotid artery and cavernous sinus

The author considers of utmost importance the anatomical arterial-venous conjugation represented by the internal carotid artery and the cavernous sinus, as well as the carotid venous plexus which covers the internal carotid artery within the petrous portion of the temporal bone. He believes that besides protecting the vascular arterial wall in acute episodes of hypertension, it can also contribute to the mechanism of carotid blood flow. This hypothesis is based on consideration of the physiological conditions of the cavernous sinus in relation to those of other dural venous sinuses, and of the endocranial venous system and its cavernous constitution, which differs from other venous blood canals, which have their own venous physiology and different functions. He attempts to compare it with the rest of the body areas where cavernous plexuses are located and where venous pressure reaches high values, and with other regions without this morphologic constitution. He establishes a correlation resulting from a cerebrovascular resistance mechanism, the participation of which he considers to differ from those of other dural sinuses and encephalic veins. He also emphasizes physiologically the carotid siphon and believes that its participation in the hemodynamics of a hypotensive patient who is lying down, facilitates blood access to the brain, thus avoiding anoxia and brain damage, within certain limits, and constitutes an additional means of body defense.     

Cavernous sinus anatomy as a basis for interpretation of the clinical picture and radiological investigations in a case of Entomophthorales infection

Several cranial nerves traverse the cavernous sinus producing the typical symptom complex seen during cavernous venous sinus thrombosis in Mucorales infection. Fungi of the order Entomophthorales display different pathological and histological characteristics although belonging to the same class of fungi. A case is presented, wherein the anatomy of the cavernous sinus forms the basis in explaining the presenting symptoms of a patient with Entomophthorales infection. The anatomical explanation for the presenting neurological symptoms is confirmed by radiological investigations and further supports the diagnosis of Entomophthorales infection.