额底-纵裂-经终板入路处理第三脑室前部病变的解剖学研究  

Anatomy of bifrontobasa interhemispheric trans-lamina terminalis approach for treating the lesion in the front part of the third ventricle

作　　者：王剑超[1] 王春莉[1] 王玉海[1] 蔡桑[1] 杨理坤[1] 陈磊[1] 蔡学见[1] 

机构地区：[1]解放军第101医院神经外科全军颅脑损伤救治中心,江苏省214044

出　　处：《江苏医药》2013年第10期1127-1129,F0002,共4页Jiangsu Medical Journal

摘　　要：目的探讨额底-纵裂-经终板入路处理第三脑室前部病变的解剖学依据。方法模拟额底-纵裂-经终板入路解剖15具彩色乳胶灌注血管的尸头,重点观察前交通动脉复合体及视路等重要结构与终板的毗邻关系。结果额底-纵裂-经终板入路至终板的平均深度63.21mm,终板长度平均11.23mm,宽度6.38mm,面积46.12mm2。前交通动脉丛位于终板上1/3或终板下1/3。前交通动脉及大脑前动脉A1段发出穿支供应终板和视交叉,穿支主要分布于终板的上外方。结论终板是处理第三脑室病变的入路标志点,通过额底-纵裂-经终板入路有助于保护垂体柄、下丘脑及重要血管和安全处理鞍区及鞍上区第三脑室前部病变。Objective To investigate the anatomical basis of bifrontobasa interhemispheric trans-lamina terminalis approach for treating the anterior lesions Of the third ventricle. Methods After the arteries and veins were perfused with colored silicone, bifrontobasa interhemispheric trans- lamina terminalis approach was examined by stepwise dissections in 15 adult cadaveric brains. The relationship between anterior communicating artery complex, visual pathway and lamina terminalis （LT） were observed. Results The length and width of LT were averagely 11.23 mm and 6.38 mm, respectively, and the area averaged 46.12 mm^2. The depth from the frontal base by interhemispheric approach to LT averaged 63.21 mm. The anterior communicating artery plexus could be located 1/3 above or 1/3 under LT. Anterior communicating artery and A1 segment of anterior cerebral artery branched off to the LT and the optic chiasm. The perforating branches to LT were distributed upwards and outwards. Conclusion The LT is a clearly identifiable microsurgical marker for the tumors in the third ventricle. The perforating branches to LT are distributed outside of it and do not interfere with LT incision. By bifrontobasa interhemispheric trans-lamina terminalis approach, it is easy to preserve the pituitary stalk, hypothalamic structures, and perforating vessels. It can offer a safe and effective treatment for the lesion in the front part of the third ventricle.

关 键 词：终板 第三脑室 额底-纵裂-经终板入路 

分 类 号：R323[医药卫生—人体解剖和组织胚胎学]