Kazumata Ken, Kamiyama Hiroyasu, Ishikawa Tatsuya, Takizawa Katsumi, Maeda Takahiro, Makino Kennichi, Gotoh Satoshi
Department of Neurosurgery, Asahikawa Red Cross Hospital, Asahikawa, Hokkaido, Japan.
Neurol Med Chir (Tokyo). 2003 Sep;43(9):427-33; discussion 434. doi: 10.2176/nmc.43.427.
Methods for preservation of the sylvian veins in the transsylvian approach have not been established because of the considerable variations. This study attempted to classify the sylvian veins to facilitate systematic dissection of the sylvian fissure for sylvian veins to be preserved. The operative anatomy of the sylvian vein was examined in 82 hemispheres. The type of drainage and the pattern of branching were investigated. The superficial sylvian vein (SSV) was classified into three types according to the number of stems draining into the dural sinus on the inner surface of the sphenoid bone: The SSV was absent or hypoplastic in eight cases, the SSV was single in 38 cases, and the SSV was double in 36 cases. The SSV drained into neither the sphenoparietal sinus nor the cavernous sinus in nine cases. An anastomosis between the SSV and the deep middle cerebral vein (DMCV) was observed in 42 cases. The frontobasal bridging vein (FBBV) drained into the sphenoparietal sinus in 47 cases. The type of connection was further subdivided into four types according to the connections with the DMCV and FBBV. The venous anatomy of sylvian fissure indicates that dissection (skeletonization) of the main stem of sylvian veins from the temporal lobe should be performed to preserve the tributaries from the frontal lobe.
由于存在相当大的变异，经侧裂入路中保留外侧裂静脉的方法尚未确立。本研究试图对外侧裂静脉进行分类，以利于对外侧裂进行系统解剖，从而保留外侧裂静脉。在82个半球中检查了外侧裂静脉的手术解剖结构。研究了引流类型和分支模式。根据引流至蝶骨内表面硬脑膜窦的主干数量，将浅表外侧裂静脉（SSV）分为三种类型：8例SSV缺失或发育不全，38例为单支SSV，36例为双支SSV。9例SSV既不引流至蝶顶窦也不引流至海绵窦。42例观察到SSV与大脑中深静脉（DMCV）之间存在吻合。47例额底桥静脉（FBBV）引流至蝶顶窦。根据与DMCV和FBBV的连接情况，将连接类型进一步细分为四种类型。外侧裂的静脉解剖结构表明，应从颞叶对外侧裂静脉主干进行解剖（骨骼化），以保留来自额叶的分支。
