下丘脑的显微外科解剖

目的：为手术切除颅咽管瘤提供下丘脑的显微解剖知识。方法：对10例游离的成人脑底组织和10例矢状正中切开脑组织的终板、三脑室底进行显微解剖和测量。结果：①终板的高度和最大宽度分别为9．3mm和7．2mm；结节漏斗区的高度、长度、外侧界、宽度分别为11．6mm、8．3mm、8．6mm、15．1mm;②前交通动脉发出3．1支穿通动脉，经过终板外侧角和上角周围进入下丘脑前部。③三脑室底的供血动脉主要包括来自视交叉下动脉、垂体上动脉、后交通动脉，以及基底动脉顶端和大脑后动脉的穿通动脉，它们之间形成网状的血管丛。结论：显微外科切除颅咽管瘤时应注意对下丘脑组织及其周围重要穿通动脉的识别和保护。

THE MICROSURGICAL ANATOMY OF THE HYPOTHALAMUS

Objective：To prepare microanatomy knowledge for microsurgical management of craniopharyngi- omas. Methods：The hypothalamuas region was examined in 10 isolated brains and 10 mid sagittal brains. The lamina terminalis, tuberal region and anterior communicating artery （ACoA） were microanatomized, observed, and measured. Results：The height and the largest width of incision of the lamina terminal was averaged 9.3 mm and 7.2 mm; respectively. The height, length, width,and the lateral border of the tuber region were 11.6 ram, 8.3 mm, 15.1 mm, and 8.6 mm; respectively. The mean number of hypothalamus perforating arteries from ACoA was 3.1. The tuberal region was mainly supplied by the superior hypophyseal arteries, the tubero-infundibular arteries arising from posterior communicating artery, branches from subchiasm vascular plexus, and perforating arteries arising from posterior cerebral artery and apex of the basilar artery. Conclusion： During the microsurgical management of craniopharyngioma, a great effort should be pay to preserve the structure of the hypothalamus. The vessles and their perforating arteries penetrating into the hypothalamus region should be identified and manipulated carefully.