CAJ | 학술논문

目的通过对上矢状窦旁大脑桥静脉的显微解剖学观察,为胼胝体前入路手术提供保护桥静脉的解刮学基础.方法对20例(40侧)上矢状窦和颈内静脉内灌注蓝色乳胶的成人头颅湿标本进行显微解剖观察.依次分离额区及中央区的桥静脉,并对其进行体表定位.观察并测量各区外侧面静脉的多项指标,如管径、条数和汇入角等.按同样的方法处理对侧半球,最后测量上矢状窦的各项指标.结果在上矢状窦额区的后部有一段没有静脉汇入的"安全区"."安全区"位于冠状缝前32.6mm和冠状缝后7.5mm之间.充分游离"安全区"纵裂邻近的桥静脉,可以增加纵裂牵开宽度(4.48～10.86)mm.结论熟悉上矢状窦旁桥静脉的解剖学特征,有利于在经胼胝体前手术入路过程中避开桥静脉;充分游离桥静脉的贴段和蛛网膜下腔段,可以增加纵裂的牵开宽度而不增加桥静脉的紧张程度,从而可以更好地保护桥静脉.
목적 통과대상시상두방대뇌교정맥적현미해부학관찰,위변지체전입로수술제공보호교정맥적해괄학기출.방법 대20례(40측)상시상두화경내정맥내관주람색유효적성인두로습표본진행현미해부관찰.의차분리액구급중앙구적교정맥,병대기진행체표정위.관찰병측량각구외측면정맥적다항지표,여관경、조수화회입각등.안동양적방법처리대측반구,최후측량상시상두적각항지표.결과 재상시상두액구적후부유일단몰유정맥회입적"안전구"."안전구"위우관상봉전32.6mm화관상봉후7.5mm지간.충분유리"안전구"종렬린근적교정맥,가이증가종렬견개관도(4.48～10.86)mm.결론 숙실상시상두방교정맥적해부학특정,유리우재경변지체전수술입로과정중피개교정맥;충분유리교정맥적첩단화주망막하강단,가이증가종렬적견개관도이불증가교정맥적긴장정도,종이가이경호지보호교정맥.
Objective To observe the microanatomy of the bridging veins emptying into the superior sagittal sinus (SSS) for preservation of the bridging veins in surgeries through the anterior transcallosal approach. Methods Blue latex was injected into the SSS and internal jugular veins in 20 cadaver heads (40 sides), in which the bridging veins of the frontal zone and central zone were dissociated and their positions relative to the body surface were determined. Such indexes of the lateral veins in each zone as the caliber, the number of bridging veins, and convergence angle were determined. The opposite hemisphere was manipulated in an identical manner to measure the indexes of the sagittal sinus. Results in an area posterior to the frontal region of the SSS, a "safe zone" was identified where no bridging veins drained into the SSS, covering the area 32.6 nun anterior and 7.5 mm posterior to the coronal suture. After complete dissociation of the bridging veins near the longitudinal fissure in the "safe zone", the fissure allowed an opening width of 4.48～10.86 mm. Conclusion Thorough knowledge of the venous anatomy can help avoid the bridging veins in the anterior transcallosal approach. Total dissociation of the sticking segment and arachnoid segment of the bridging veins can broaden the opening width of the longitudinal fissure without increasing the tension of the bridging veins to better preserve the bridging veins during surgery.