目的 观察小脑动脉的起始位置、行程特点及其与三叉神经根的毗邻关系,为三叉神经微血管减压术提供解剖学依据。 方法 采用12个福尔马林固定的成人头部标本,在手术显微镜下分别解剖小脑上动脉、小脑下前动脉、小脑下后动脉及三叉神经等结构。观察相关动脉、神经的位置、走行特点,测量上述动脉的起始段外径及其与三叉神经根最近距离等相关数据。 结果 共发现小脑上动脉27支,2支压迫三叉神经根,5支与神经根接触,其余无接触压迫者与三叉神经的最近距离为(3.87±1.58) mm(0.55~6.30 mm);小脑下前动脉23支,压迫神经根1例,与之接触者2例,其余20支小脑下前动脉与三叉神经根最近距离为(4.67±1.77)mm(2.65~9.50 mm);小脑下后动脉21支,与三叉神经根最近距离为(17.12±3.86) mm(10.45~25.70 mm),未发现与之接触或压迫者。 结论 小脑上动脉与三叉神经关系密切,常与三叉神经接触并压迫神经,成为三叉神经痛发生的主要结构。小脑下前动脉与三叉神经相距稍远,也可与三叉神经接触或压迫神经。小脑下后动脉与三叉神经相距较远,但偶尔也会压迫三叉神经根导致三叉神经痛。
Abstract
Objective To observe the anatomy of the Chinese cadaver specimens, the initial position of the cerebellar artery, the characteristics of the course and the adjacent relationship between the cerebellar artery and the trigeminal nerve roots, providing anatomical basis for the trigeminal microvascular decompression operation. Methods Twelve adult cadaveric specimens fixed in formalin were collected, the superior cerebellar artery, anterior inferior cerebellar artery, posterior inferior cerebellar artery and trigeminal nerve were dissected microscopically. At the same time, the location of the relevant arteries, nerves, and walking characteristics were observed, and the outer diameter of the initial segment of the artery and its closest distance to the trigeminal nerve root were measured. Results A total of 27 superior cerebellar arteries were found in 12 cadaveric heads, 2 of which compressed trigeminal nerve roots, 5 of which branches contacted with nerve roots, and the closest distance between the remaining non-contacted and the trigeminal nerves was (3.87±1.58) mm(0.55~6.30 mm). There were 23 cases of anterior inferior cerebellar arteries, 1 of them compressed nerve root, 2 of them contacted with nerve roots, and the nearest distance with trigeminal nerve roots was (4.67±1.77) mm(2.65~9.50 mm). Twenty-one posterior inferior cerebellar arteries were found, and the closest distance to the trigeminal nerve root was (17.12±3.86) mm (10.45~25.70 mm), and there was no contact or compression between the arteries and nerve roots. Conclusions The superior cerebellar arteries are closely related to the trigeminal nerve roots and often contact with the roots and compresses them, which is the main anatomical basis for the occurrence of trigeminal neuralgia. The anterior inferior cerebellar artery is slightly apart from the trigeminal nerve, and can also contact with the trigeminal nerve or compress the nerve, which is one of the anatomical foundation of trigeminal neuralgia.
关键词
小脑上动脉 /
小脑下前动脉 /
小脑下后动脉 /
三叉神经 /
应用解剖
Key words
Superior cerebellar artery /
Anterior inferior cerebellar artery /
Posterior inferior cerebellar artery /
Trigeminal nerve /
Applied anatomy
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基金
潍坊医学院教研课题实践教学改革与研究专项(2019ZXSJ001)