岛叶形态结构特点、毗邻关系及相关入路的解剖学研究  

Anatomy study of the insula, its peripheral structures and its surgical approaches

作　　者：梁鹏[1] 刘祥玉[1] 武宏杰[1] 梁洪生[1] 吴佳宁[1] 徐小平[1] 孔凡勇[1] 

机构地区：[1]哈尔滨医科大学附属第一医院神经外科,哈尔滨150001

出　　处：《中华神经医学杂志》2010年第1期82-86,共5页Chinese Journal of Neuromedicine

摘　　要：目的提供岛叶及其相邻结构的解剖数据以指导该区域的显微外科手术，以期更好的完成岛叶相关手术入路。方法对15具（30侧）经10％福尔马林固定的国人成年头颅标本进行研究．测量和描述岛叶自身解剖结构标志及其与周围相关结构的距离。结果岛叶是旁边缘结构的一部分，它构成大脑皮层的内陷部分，形成外侧裂的基底部。岛叶由额眶盖、额顶盖和颞盖共同围成的岛盖部包绕，内侧移行为钩状的最外囊即为岛叶皮质下的白质部分，向内与外囊、屏状核、内囊、豆状核、尾状核和背侧丘脑相邻，形成一个倒金字塔形的结构分隔端脑与边缘结构。结论熟悉岛叶及其周围结构的显微解剖，能指导术者经岛叶入路治疗基底节区脑出血、岛叶胶质瘤、颞叶癫痫等该区域的一系列神经外科的多发病与常见病。Objective To define the anatomical characteristics of the insula and its relation with its surrounding structures that can lead to precisely design the microsurgical approaches of the insular region. Methods We analyzed the head data of 15 Chinese adult cadavers （30 hemispheres） fixed by 10% formalin. The relative anatomical landmarks of the insular region and the distance from the insula to its peripherally correlative structures were measured and described. Results The insula, being one of the paralimbic structures, constituted the invaginated portion of the cerebral cortex and formed the base of the sylvian fissure. The insula was covered and enclosed by the frontoorbital, frontoparietal and temporal opercula and the transmigrated part of the insula was the uncinate extreme capsule, the white matter region inferior to the insular cortex. The insula was adjacent to the external capsule, the claustrum, the internal capsule, the lenticular nucleus, the caudate nucleus and the thalamus. The insula separated the endbrain and the limbic structures like an inverted pyramid, Various unique anatomical features of the insula and the peripheral relations with the insula were determined by using the fiber dissection techniques. Conclusion A good understanding of the surgical anatomy, being extremely important for a neurosurgeon, can guide us to operate for such series of frequent and multiple diseases as hypertensive intracerebral hemorrhage from the basal ganglia, the insular glioma and temporal lobe epilepsy in the neurosurgery.

关 键 词：岛叶 局部解剖学 手术入路 

分 类 号：R322.81[医药卫生—人体解剖和组织胚胎学]