Lüdemann W, Schneekloth C, Samii M, Hussein S
Department of Neurosurgery, Medical School Hannover, 30625 Hannover, Germany.
Surg Radiol Anat. 2001;23(1):39-43. doi: 10.1007/s00276-001-0039-5.
The mesiobasal limbic system is of particular significance in the surgical treatment of temporo-medial tumors and epilepsy. It consists of the uncus, amygdaloid body, hippocampus, dentate gyrus, subiculum, fasciolar gyrus and the parahippocampal gyrus. Knowledge of the vascular microanatomy is a key to the surgical treatment of pathologies in the region. The anterior choroidal artery was selectively injected in fresh brain specimens: 50 specimens with a gelatinous ink mixture to demonstrate vascular territories in stereotactic brain slices, and 50 with a Biodur resin to obtain casts for microanatomical evaluation. The cast technique was also applied to 35 specimens injected into the posterior cerebral artery. The rostral third of the temporomedial region is mainly supplied by branches of the anterior choroidal artery. The occipital two thirds are supplied by hippocampal branches, the posteromedial choroidal artery and the inferior temporal branches of the posterior cerebral artery. Important vessel variations with significant implications for the preoperative Wada-test are presented.
中脑基底边缘系统在颞叶内侧肿瘤和癫痫的外科治疗中具有特殊意义。它由钩回、杏仁体、海马、齿状回、下托、束状回和海马旁回组成。了解血管微解剖结构是该区域疾病外科治疗的关键。在新鲜脑标本中选择性注入脉络膜前动脉：50个标本注入凝胶状墨水混合物以在立体定向脑切片中显示血管分布区域，50个标本注入生物耐久性树脂以获得用于微解剖评估的铸型。铸型技术也应用于35个注入大脑后动脉的标本。颞叶内侧区域的前三分之一主要由脉络膜前动脉的分支供血。后三分之二由海马分支、脉络膜后内侧动脉和大脑后动脉的颞叶下分支供血。还介绍了对术前Wada试验有重要影响的重要血管变异情况。
