摘要
目的探讨环池前部的显微结构及其临床意义。方法在手术显微镜下,观测15例尸颅的环池前部。结果环池前部主要居于小脑幕上方,常与小脑桥脑池隔有蛛网膜。其内侧壁为中脑及桥脑上部的外侧面,外侧壁为钩和海马旁回的内侧面,顶壁为视束下面的软膜反折。颞叶均有纵行压迹同小脑幕切迹相对应,多数压迹与钩无关。环池前部主要含有脉络膜前动脉、基底静脉及大脑后动脉P2段,纤维小梁不多,多为散在的短纤维。结论钩仅小部分位于前切迹空间,跨幕切迹向内侧伸展的脑组织以海马旁回前部为主,小脑幕切迹下疝的前疝若改称海马旁回疝将更为合适。颞叶与动眼神经的间距变异较大,所以,有些人容易出现瞳孔改变,有些人则不容易发生。切除海马前部和钩时,应沿脉络丛的下面作软膜下分离,否则容易损伤视束、基底静脉及脉络膜前动脉。
Objective To study the microstructures and their clinical significance of the anterior part of ambient cistern.Method Ambient cisterns were observed in15cadeveric heads under an operating microscope.Result The anterior part of ambient cistern was mainly superior to tentorium of cerebellum.It was often separated from cerebellopontine cistern by a sheet of arachnoid.The medial wall was the lateral surface of midbrain and upper pons.The lateral wall was medial surface of the uncus and parahippocampal gyrus.The roof wall was the folding of pia mater lining inferior surface of optic tract.There was a longitudinal groove on lower surface of temporal lobe along tentorial incisura in every case.Most grooves had nothing to do with uncus.Anterior part of ambient cistern mainly contained anterior choroidal artery,basal vein of Rosenthal and P2segment of posterior cerebral artery.The fibrous trabeculae were not much in the cistern.Most trabeculae were scatter and short.Conclusion Ambient cistern is a supratentorial one on the whole.Most of the cisterns have lower walls.Only small part of uncus lies in anterior incisural space.The cerebral tissue that extends medially across the tentorial incisura is mainly the anterior part of parahippocampal gyrus.It should be more suitable that anterior type of descending tentorial herniation be renamed to be the herniation of parahippocampal gyrus.The distance between temporal lobe and oculomotor nerve varied one from one,therefore,the pupil sizes of some individuals can change easily in the situation of herniation,but others can not.When the anterior part of hippocampus and uncus are being resected,dissociation should be along inferior surface of pia mater and inferior to choroid plexus,otherwise optic tract,basal vein and anterior choroidal artery can be damaged rashly.
出处
《中国微侵袭神经外科杂志》
CAS
2002年第3期162-165,共4页
Chinese Journal of Minimally Invasive Neurosurgery
基金
福建省自然科学基金资助项目(C0110027)
关键词
环池
蛛网膜下池
显微解剖
神经外科手术
mbient cistern
subarachnoid cistern
microanatomy
neurosurgery
