经外侧裂-岛叶手术入路清除基底节血肿的显微解剖  

Microsurgical anatomy of transsylvian fissure-insular surgical approach for removal of intracerebral hematoma in basal ganglia region

作　　者：王东[1] 

机构地区：[1]南京医科大学附属江宁医院神经外科,江苏省211100

出　　处：《江苏医药》2014年第10期1178-1180,共3页Jiangsu Medical Journal

摘　　要：目的探讨经外侧裂-岛叶入路治疗基底节脑出血的显微解剖。方法对10例(20侧)成人尸头标本进行外侧裂、岛盖、岛叶、大脑中动脉、基底节的相关解剖。结果 (1)外侧裂的表面有3个分支与岛盖关系密切,为暴露岛叶提供有利条件;(2)岛叶外形呈三角锥形,表面由4-7个岛回组成,周围以环岛沟为界与额顶颞叶分隔开;(3)大脑中动脉M2段是岛叶唯一供血动脉,在岛叶表面向后上扇形展开,并发出许多微小的穿支血管供应岛叶皮层;(4)岛叶的中部水平切面上,岛叶的中后短回垂直向内对应了壳核最为宽阔的部分和内囊的膝部。结论熟悉外侧裂-岛叶手术入路中的解剖,有利于针对基底节区血肿的手术治疗。Objective To study the microsurgical anatomy via transsylvian fissure-insular surgical approach in the removal surgery of intraccerebral hematoma in basal ganglia region. Methods Dissection and relative measurement were performed in the sylvian fissure, operculum insalae, insular, middle cerebral artery and basal ganglia of 10 adult cadaverie heads（20 hemispheres）. Results There are 3 branches on the surface of the sylvian fissure, which has a close relationship with the operculum insulae, making the exposure of the insular more easy. The insular is triangle in shape because of the pyramidal configuration and is surrounded by anterior, superior and inferior limiting sulci with 4-7 insular gyri on the surface. The M2 of the middle cerebral artery provides the soto supply for the insula, expanding backward and upward on the surface of insula in a shape of fan, and the terminal tiny perforating arteries of the M2 segments provide the supply to the insula. On the middle horizontal section of the insula, the middle and post short gyrus point inward to the widest part of the putanen and the genu of the intimal capsule. Conclusion It is important for neurosurgeon to have a good understanding of the microsurgieal anatomy during surgery of intracerebral hematoma in basal ganglia region via transsylvian fissure-insular surgical approach.

关 键 词：颅内出血 脑基底节 手术入路 

分 类 号：R651[医药卫生—外科学]