Guerin J, Gouaze A, Lazorthes G
Neurochirurgie. 1976 May-Jun;22(3):217-26.
The pattern of the circulus arteriosus cerebri was studied on the sagittal plane in 41 brains taking off on children from birth to 14 years. Internal diameters were measured on the segments of the circulus, on the cortical efferent vessels and on the internal carotid afferent arteries. In only 17/41 cases, a symetry of the segment of the cortical efferent branches and of the carotid arteries. We found different factors associated with the assymetry of the circulus arteriosus, namely cerebral conditions as demonstrated in our pathological cases and embryological dispositions. Three grades are proposed according anatomic criteria. They are related to a greater complexity and interaction of the conditions mentionned above:-grade 1 "foetal" : symetry is complete;-grade 2 : there is a symetry of the cortical branches, but an assymetry of the circulus arteriosus, which is obtained by compensatory modelling of the circulus arteriosus, working to equalize the cerebral flow; -grade 3 : there is an assymetry of the circulus and of the cortical efferent branches suggesting a failure of adaptation. It is assumed that this modelling of the circulus has consequences on adult anatomic and functional conditions. Indeed, the other modelating factors which affect the adult circulus refer mainly to the grade obtained in childhood.
对41例从出生到14岁儿童的大脑矢状面的脑动脉环模式进行了研究。测量了脑动脉环各段、皮质传出血管和颈内动脉传入动脉的内径。在41例中只有17例，皮质传出分支段和颈动脉呈对称。我们发现了与脑动脉环不对称相关的不同因素，即在我们的病理病例中显示的脑部状况和胚胎学倾向。根据解剖学标准提出了三个等级。它们与上述情况的更大复杂性和相互作用有关：- 1级“胎儿型”：对称完全；- 2级：皮质分支对称，但脑动脉环不对称，这是通过脑动脉环的代偿性重塑实现的，以平衡脑血流；- 3级：脑动脉环和皮质传出分支不对称，提示适应失败。据推测，这种脑动脉环的重塑对成人的解剖和功能状况有影响。事实上，影响成人大脑动脉环的其他重塑因素主要与儿童期获得的等级有关。
