脑动脉硬化对视神经血供影响的形态学研究及其临床意义

①目的 探讨视神经动脉起源、数目、分布及相关动脉的病理变化，为视神经因缺血所致视野缺损提供形态学依据。②方法 在体视显微镜扣手术显微镜下对100侧成人脑标本观察视神经动脉来源、数目和分布，对其中年龄50-70岁60侧脑标本的视神经和相关动脉进行病理切片观察。③结果 视神经动脉主要来源于颈内动脉、大脑前动脉争前交通动脉。其中单来源3侧(3％)，双来源68侧(68％)，3来源29侧(29％)。病理切片观察动脉管壁有粥样硬化改变53侧(88．3％)，其中被硬化斑块阻塞眼动脉的3侧(5、7％)。阻塞垂体上动脉的4侧(7．5％)，小动脉管腔狭窄11侧(20．8％)。与小动脉阻塞相对应的视神经切片。可见有神经纤维萎缩、变性等病理改变。硬化的颈内动脉壁压迫视神经可以形成明显的压迹。④结论 50岁以上出现不明原因的周边或中央视野缺损。脑动脉硬化导致视神经供血障碍病因不能除外。

Morphological study of optic nerve blood supply affected by brain atherosclerosis and its clinical significance

Objective In order to provide morphological evidences for visual field defect caused by optic nerve ischemia , the origins, numbers, distributions and pathological changes about optic nerve arteries were studied. Methods The origins, numbers, distributions and pathological changes of optic nerve arteries in 100 sides of adult brain specimens were observed with microsteroscope and operation microscope, among which the nourishing arteries of optic nerve in 60 sides aged from 50 to 70 were done pathonistologicaUy. Results The blood supply of optic nerve comes mainly from internal carotid,anterior artery and anterior communicating artery. 5% of the arteries in 60 sides were mono - origin;58. 3% of them were three origins and 88. 3% of them have atherosclerosis. The eye arteries in 3 sides and the superior hypophyseal arteries were blocked completely and 11 sides were blocked partly. There were obvious impressions on the optic nerves from compressions by the scleerosed internal carotid arteries, pathological changes in optic nerve, for example, the neual fiber atrophy, were observed. Conclusion Excluding other disease, the eyesight declining, visual field (especially the surrunding and the central part) in patients over 50 years old were caused possibly by atherosclerosis of the arteries at the brain.