桥小脑角区上血管神经复合体的显微解剖学研究  

Microanatomical study of the upper neurovascular complex in the cerebellopontine angle(CPA) region

作　　者：张庆华[1] 孙涛[1] 田继辉[1] 宋家仁[1] 张莉[1] 

机构地区：[1]宁夏医学院附属医院神经外科,银川750004

出　　处：《中华神经外科杂志》2005年第7期416-419,共4页Chinese Journal of Neurosurgery

摘　　要：目的研究桥小脑角区上血管神经复合体显微解剖.方法应用15例经10%甲醛充分固定并灌有乳胶的国人成人头颅湿标本,模拟临床枕下乙状窦后手术入路,在4～25倍手术显微镜下逐层解剖,观察,测量及照相.结果桥小脑角区上血管神经复合体主要包括三叉神经和相关的小脑上动脉、岩静脉及中脑、中脑小脑沟、小脑上脚、小脑幕面.小脑上动脉的行程一般比较恒定,向尾侧凸起的46.88%的尾袢对三叉神经造成压迫.结论桥小脑角区上血管神经复合体位置深在,结构复杂且周围毗邻脑干、小脑动脉及颅神经等重要的结构,详尽的解剖研究可提高显微血管减压手术成功率并且尽可能保存神经功能的完整.Objective To investigate the microanatomical structures of the upper neurovascular complex. Methods 15 adult cadaveric heads fixed in 10% formalin were used for this study. The heads were placed in a head holder in a position simulating the trans-suboccipital retrosigmoid approach to the CPA region. Dissections were performed under x4 to 25 magnification. Results To investigate the relationships of the cerebellar arteries with the cranial nerves, brainstem, cerebellar peduncles, fissures between cerebellum and brainstem. When examining these relationships, the upper neurovascular complex are defined as: an upper complex related to superior cerebellar artery , trigeminal nerve, and midbrain cerebelomesencephalic fissure, As a result, about 46.88% of SCA has a point of contact with the trigeminal nerve. Conclusions The upper neurovascular complex in the cerebellopontine angle, which is adjacent to the brainstem, arteries of cerebellum and cranial nerves, is deep-seated and intricate in structure. Thorough anatomical study can help to improve the success in MVD surgery, as well as satisfactory functional survival of the patient.

关 键 词：上血管神经 桥小脑角区 复合体 解剖学研究 枕下乙状窦后手术入路 小脑上动脉 显微血管减压 头颅湿标本 手术成功率 显微解剖 模拟临床 显微镜下 三叉神经 小脑动脉 神经功能 解剖研究 岩静脉 小脑幕 颅神经 中脑 结构 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]