Galen静脉系的解剖变异及其临床意义  

Anatomical Variance of Galen Venous System and Its Clinical Application

作　　者：贤俊民[1] 丰育功[1] 焦迎宾[1] 张丽云[1] 

机构地区：[1]青岛大学医学院附属医院神经外科一病区,山东青岛266003

出　　处：《中国临床神经外科杂志》2009年第1期33-36,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的对Galen静脉系统的解剖构成进行研究,探讨其解剖变异性对幕切迹后区病变手术治疗的影响。方法利用20具(40侧)尸头标本,动、静脉分别用红、蓝色乳胶灌注,在显微镜下模拟枕下经小脑幕上入路和幕下小脑上入路,观察阻碍进入幕切迹后区的Galen静脉系的属支,并对Galen静脉系的构成进行统计、观察并测量相关的数据。结果Galen静脉系的构成可分为五种类型。9侧(22.5%,9/40)枕内侧静脉明显粗大,外径为(2.5±0.4)mm,基底静脉前中后段均可缺如;5具(25.0%,5/20)小脑中央前静脉明显粗大,其外径为(2.0±0.2)mm。枕下经小脑幕上入路时可能阻碍进入幕切迹后区的是枕内侧静脉、基底静脉,幕下小脑上入路时可能阻碍进入幕切迹后区的是小脑中央前静脉。结论Galen静脉系及其属支的构成变异性大,为减少不必要的出血和术后并发症,神经外科医师应注意术前应用颅脑CT血管造影或磁共振静脉造影对Galen静脉系及其属支的构成及其与病变的位置关系进行评估,选择最佳的手术入路。Objectives To study the composition of the Galen venous system and explore effects of its anatomical variance on microsurgery for the lesions in the region in the back ＇of tentorial incisure space. Methods The transoecipito-supratentorial and infratentorial supracerebellar approaches were simulated in 20 （40 hemispheres） formalin fixed adult eadaveric brains in which the cerebral arteries and ＂eins had been perfused respectively with red and blue latex＇. The tributaries of Galen venous system, which interfered in entering the region in the back of the incisural space, were observed under an operating microscope. The composition of Galen venous system a-d datums related to it were analyzed and measured. Results Galen venous system was divided into five types according its composition. The thick medial occipital veins, of which, the outer diameter was （2.5±0.4）mm, were identified in 9 （22.5%, 9/40） sides of the hemispheres. The thick precentral cerebellar veins, of which, the outer diameter was （2.0±0.2）mm, were also identified in 5 （25.0%, 5/20） brains. The defect of anterior or middle or posterior segments of the basal veins of Rosenthal was observed in some dissected specimens. The medial occipital veins and the basal vein of Rosenthal interfered in entering the region in the back of the tentorial incisural space when mierosurgery through the transoccipito-supratentorial approach was performed, and the precentral eerebellar veins possibly interfered in entering the region of the back of the tentorial incisural space when the microsurgery the infratentorial supracerebellar approrch was performed. Conclusions Galen venous system and its tributaries are highly variable anatomically. The anatomical variance of the Galen venous system, its tributaries and their relationship with the lesions should be preoperatively estimated by computerized tomographic angiography or MR venography of brain, and the optimal operative approach should be selected to reduce intraoperative bleeding and the post

关 键 词：GALEN静脉 显微解剖 手术入路 

分 类 号：R322.123[医药卫生—人体解剖和组织胚胎学]