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目的通过对视交叉侧动脉特点的显微解剖学研究,探讨其在垂体瘤致视功能障碍中的意义。方法10例福尔马林固定的国人成人头颅标本,经双侧颈内动脉和椎动脉灌注红色乳胶后取脑,手术显微镜下剥离鞍区蛛网膜,暴露颈内动脉颅内段、Willis环及其穿动脉,以及垂体柄、视交叉、大脑脚、乳头体等鞍区重要结构。观察视交叉侧动脉的起始、走行、分支和分布,测量其起始部的直径并显微摄影。结果视交叉侧动脉自颈内动脉C2段内侧壁发出,在蛛网膜下腔迂曲走行,起始部位靠上,几乎与视交叉处于同一水平,直径(0.18±0.06)mm,在到达视交叉之前发出2～3条亚支,呈“分水岭”样分布于视交叉侧缘、视交叉侧部的上面和下面(以下面为主)靠外侧的部分以及视神经近视交叉处外侧半。视交叉侧动脉具有较长的脑外游离段,各穿动脉主干之间不吻合,而在软膜上与邻近穿动脉之间存在广泛的终末吻合。结论垂体瘤不易累及视交叉侧动脉可能是垂体瘤患者鼻上象限视野往往可以长时间保留的原因。
Objective To investigate the significance of optic chiasm in optic dysfunction by observing the characteristics of optic chiasm by microanatomy. Methods Ten adult formalin - fixed adult skull specimens were infused with red latex through bilateral internal carotid artery and vertebral artery. The brachial arachnoid was dissected under the microscope and the internal carotid artery segment, Willis ring, Its wear artery, as well as the pituitary stalk, optic chiasm, cerebral feet, nipple and other important structures of the saddle area. The onset, course, branching and distribution of the visual cusp-lateral artery were observed, the diameter of the starting portion was measured and micrographs were taken. Results The optic chiasm was originated from the medial wall of C2 segment of the internal carotid artery. In the subarachnoid space, the tortuous pathways began to run. The initial part was up, almost at the same level as the optic chiasm. The diameter was (0.18 ± 0.06) mm before reaching the optic chiasm Issued 2 to 3 sub-branch, was “watershed ” like distribution in the lateral edge of the optic chiasm, depending on the upper and lower side of the cross-sectional side (mainly below) and the lateral part of the outer half of the optic nerve myopia. The optic chiasm artery has a long extracerebral free segment, the main artery of each artery does not match, and there is a wide range of terminal agreement between the soft membrane and the adjacent perforating artery. Conclusions Pituitary tumor is not easy to involve the optic chiasm side of the artery may be pituitary tumor in patients with nasal quadrant vision often can be retained for a long time reasons.