翼点入路对大脑中动脉主干分支及中央支的显微应用解剖

目的：探索经翼点入路对大脑中动脉及其分支的显微应用解剖及其临床应用。方法：对10具（20侧）红色乳胶颈内动脉和椎动脉灌注头颈部标本,于翼点入路下对大脑中动脉及其分支在手术显微镜下解剖观测。结果：大脑中动脉是颈内动脉的直接延续,其发出后先水平向外行为水平段M 1,然后分为M 2-M 5段。大脑中动脉的中央支动脉分为内侧群和外侧群;内侧群：在大脑中动脉起点1 cm内,约3-6支,多呈直角发出,较短而细;外侧群：从大脑中动脉起点1cm以外发出,约4-8支,多起源于大脑中动脉分叉处2mm范围内。结论：大脑中动脉主干为颈内动脉的延续,供血范围内易栓塞。其起始M 1、M 2段上壁、内侧壁发出的中央支多呈直角状,临床上易破裂出血。在M 1、M 2段下壁解剖可避免损伤其穿通支血管。

Microsurgical anatomy of the pterional approach, to the middle cerebral artery and their clinical signification

Objective: To study more detailed anatomic datum of the middle cerebral artery and its perforating arteries through pterional approach.Methods:Microsurgical anatomy and measurement about the perforating arteries were performed in both sides of 10 adults red-latex perfused cadaver heads along with the path of pterional approach under the surgical microscope.Results:Middle cerebral artery was the continue from inner carotid artery,and then the middle cerebral artery divided into M1 to M5 segments.Most perforating arteries arose from superior,medial-superior of middle cerebral artery and coursed superiorly to the center of brain.The perforating arteries were divided into two groups: the inner group and outer group.Many outer group perforating arteries arose from the beginning level of M2 segment within 2mm.Conclusion:There are many perforating arteries arose from middle cerebral artery with a right-angle,and the speed of blood in middle cerebral artery very high,which may be related to the block and bleeding of cerebra.M1 and M2 segment should be dissected at their underside,that the injury of the perforating arteries which arising from M1 and M2 can be avoided.