小脑动脉的临床解剖探讨.doc

小脑动脉的临床解剖探讨 惠国桢 夏春林 摘要 目的: 为神经外科临床提供解剖学资料。方法: 手术显微镜下观察50例成人脑标本小脑动脉 的起始、行径、主要分支、穿动脉及大致分布, 检查各小脑动脉与出入脑干的颅神经的接触关系。结果: 50例人脑有小脑下后动脉 (P ICA ) 94支, 小脑下前动脉 (A ICA ) 97支和小脑上动脉 (SCA ) 112支。2 侧 P ICA 和12侧 SCA 接触三叉神经根, 2侧A ICA 接触面神经根, 动脉与神经根接触多形成压迹。结论: 小脑动脉的局部解剖有助于神经外科医生在颅后窝手术时, 对这些动脉尤其是行程可能有变异的动脉 及穿支要特别谨慎, 避免损伤, 并保护与小脑动脉关系密切的脑神经根; 对某些脑干血管综合征患者及 某些三叉神经痛、面肌痉挛患者采取相应的治疗。 关键词 小脑动脉 颅后窝手术 解剖 The c l in ica l ana tom y of cerebe llar ar ter ie s H u i G u oz h en , X ia C h u n l in. D ep t of N eu rosu rg e ry , S u z h ou M ed ica l C ol leg e, S u z h ou 215006 A bstrac t O b jec t ive: T o p ro v ide th e ana tom ica l da ta fo r neu ro su rge ry. M e tho d s: U nde r op e ra t ive m ic ro scop e th e o r ig in s, co u r se s, b ranch e s, and d ist r ibu t io s o f th e ce rebe lla r a r te r ie s w e re exam ined in 50 po stm o r ta l adu lt b ra in s. R e su lt s: T h e ce rebe lla r a r te r ie s com p r ise o f th e po ste r io r infe r io r ce rebe lla r a r te ry ( P ICA ) , th e an te r io r infe r io r ce rebe lla r a r te ry (A ICA ) , and th e sup e r io r ce rebe lla r a r te ry (SCA ). T h e re a re 94 P ICA and 112 SCA in 50 b ra in s. Tw o P ICA and 12 SCA co n tac t th e roo t o f t r igem ina l ne rve. Tw o A ICA co n tac t th e roo t o f fac ia l ne rve. Co nc lu sio n s: T h e ana tom ica l da ta o f th e ce rebe lla r a r te r ie s a re nece ssa ry fo r safe neu ro su rg ica l op e ra t io n s in th e po ste r io r c ran ia l fo ssa. G rea t ca re m u st be tak en to avo id dam age to th e ve sse ls and th e ne rve s. T h e f ind ing s o b se rved in th is study m ay h e lp th e neu ro su rgeo n s and neu ro lo g ist s to exp la in som e sym p to n s and sign s in p a t ien t s w ith ce r2 ta in va scu la r synd rom s o f th e b ra in stem , o f w ith t r igem ina l neu ra lg ia, o f w ith fac ia l sp a sm , and to m anage th e se p a t ien t s. Key words C e rebe lla r a r