“椎动脉-硬膜动脉导管韧带”的解剖学及临床意义

孔祥玉, 杜心如, 刘宏伟, 王佳佳

中国临床解剖学杂志 ›› 2020, Vol. 38 ›› Issue (6) : 635-638.

中国临床解剖学杂志 ›› 2020, Vol. 38 ›› Issue (6) : 635-638. DOI: 10.13418/j.issn.1001-165x.2020.06.003
应用解剖

“椎动脉-硬膜动脉导管韧带”的解剖学及临床意义

  • 孔祥玉1, 杜心如2, 刘宏伟3, 王佳佳4
作者信息 +

Anatomical observation on vertebral artery-dura mater arterial ductal ligament and its clinical significance

  • KONG Xiang-yu1, DU Xin-ru2, LIU Hong-wei3 , WANG Jia-jia4
Author information +
文章历史 +

摘要

目的 探讨椎动脉第3段(V3段)的垂直段(V3v段)与硬膜囊前壁和周围骨性结构间的连接及其临床意义。  方法 头颈标本16具(32侧),在C3~4节段,将V3段周围的软组织及其相关联的连接结构分离,探寻“椎动脉-硬膜动脉导管韧带”,观察其解剖学特点。取该韧带与椎动脉壁相连部,石蜡切片、HE染色,光镜观察、摄片。  结果 所有标本在寰枕关节后内侧V3v段发现“椎动脉-硬膜动脉导管韧带”共11条(43.7%),长度9.25~4.76 mm,平均(7.39±1.33)mm,直径为(1.16±0.15)mm。该韧带出现于硬膜外层,自V3v段发出,末端分叉或呈分枝状穿入枕骨或连于硬膜。组织学特点为空心管状,管腔与椎动脉相通。  结论 “椎动脉-硬膜导管韧带”是椎动脉连于硬膜和骨之间的空心圆索状结构,可能是椎动脉的脑膜后动脉闭锁形成,是有孔型椎动脉畸形的形态学基础,其对椎动脉的固定及头活动时颅内压的形成有一定作用。枕颈部显露椎动脉时此结构断裂可能是造成椎动脉大出血的原因。

Abstract

Objective  To explore the fibrous connection structures between third section (V3 segment) of vertebral artery and dura mater sac as well as the surrounding bony structures of the occipital bone and also to explore the functional significance and discuss the clinical significance in hemorrhage caused by the vertebral artery rupture in operation. Methods Sixteen head linking neck specimens (32 sides) were selected for this investigation. The soft tissues surrounding the V3 segment of vertebral artery and the correlative connecting structure were separated. The vertebral artery-dura mater arterial ductal ligament were found and identified, their morphology and anatomical characteristics were observed. Choosing the typical vertebral artery-dura mater arterial ductal ligament to be cut into slices and stained by HE, and observed and photographed microscopically. Results Eleven (accounting for 43.7%) pieces of vertebral artery-dura mater arterial ductal ligament were founded among 32 sides of 16 head linking neck specimens. The longest length was 9.25 mm,the shortest was only 4.76mm. The average caliber and length were (1.16±0.15) mm and (7.39±1.33) mm respectively. The vertebral artery-dura mater arterial ductal ligament located deep to the dura meter, originated from the V3v sections and inserted either into the dura mater or into the bony structure by bifurcated several branches. The observation under light microscope showed that the histological characteristics were centrally hollow or tubular figuration, their lumen was connected with vertebral artery. Conclusions Vertebral artery-dura mater arterial ductal ligament is an arterial ligament connected between the V3 segment of vertebral artery and dura mater or basal part of the occipital bone. It is presented as a round tubular ligamental structure formed by occluded arterial branch arising from V3 segment of vertebral artery, it may have stationary function for V3v sections and have close relations with negative pressure formation in the cranial cavity.

关键词

椎动脉 /  椎动脉-硬膜动脉导管韧带 /  硬脑膜 /  出血

Key words

Vertebral artery /  Vertebral artery -dura mater arterial ductal ligament /  Dura mater / Hemorrhage

引用本文

导出引用
孔祥玉, 杜心如, 刘宏伟, 王佳佳. “椎动脉-硬膜动脉导管韧带”的解剖学及临床意义[J]. 中国临床解剖学杂志. 2020, 38(6): 635-638 https://doi.org/10.13418/j.issn.1001-165x.2020.06.003
KONG Xiang-yu, DU Xin-ru, LIU Hong-wei , WANG Jia-jia. Anatomical observation on vertebral artery-dura mater arterial ductal ligament and its clinical significance[J]. Chinese Journal of Clinical Anatomy. 2020, 38(6): 635-638 https://doi.org/10.13418/j.issn.1001-165x.2020.06.003
中图分类号: R323.1   

参考文献

[1]  Caplan LR, 王晶, 刘丽萍, 等. 椎动脉颅内段: 一个被忽视的区域[J]. 中国卒中杂志, 2013, 8(4): 301-311.
[2]  付万新, 康春华, 彭志强, 等. 远外侧人路手术中椎动脉颅内段的显微解剖应用研究[J]. 中华神经医学杂志, 2010, 8(8): 794-798.
[3]  李小海, 李晓兰. 影像学在椎动脉V3段相关解剖及寰枢椎手术中的应用[J]. 现代医药卫生, 2015, 31(19): 2927-2930.
[4]  程昊, 余资江, 贾宝山, 等. 枕下三角和椎动脉第三段的应用解剖学研究[J]. 医学信息2011, 24(3): 887-888.
[5]  刘树伟, 丁自海, 主译. 脑膜中动脉[M]//格氏解剖学. 41版. 济南:山东科技出版社, 2017: 548-549. 
[6]  Wen HT, Rhoton AL Jr, Katsuta T, et al. Microsurgical anatomy of the transcondylar supracondylar, and paracondytar extensions of the farlateral approach[J]. J Neurosurg, 1997, 87(4): 555-585.
[7]  白敏, 赵立冬, 郭茜. 颈动脉和椎-基底动脉间吻合血管变异的MR诊断[J]. 中华放射学杂志, 2018, 52(70): 502-506.
[8]  孙国生, 于胜波, 姜文斌, 等. 人枕下区肌硬膜桥及其连接形式的扫面电镜观察[J]. 解剖学杂志, 2018, 41(4): 422-425.
[9]  Xu Q, Liu C, Yuan XY, et al. Anatomical parameters of the rectus capitis posterior minor muscle based on a new magnetic resonance scan method[J]. Int J Morphol, 2017, 35(3): 1010-1015.
[10]蒋飚, 何伟良, 许晓英, 等. 有孔型椎基底动脉的MRI血管成像诊断[J]. 中华放射学杂志, 2004, 38(5): 522-528.

Accesses

Citation

Detail

段落导航
相关文章

/