布雷谢蝶顶窦：它存在吗？一项解剖学研究。
The sphenoparietal sinus of breschet: does it exist? An anatomic study.
作者信息
San Millán Ruíz Diego, Fasel Jean H D, Rüfenacht Daniel A, Gailloud Philippe
机构信息
Groupe de Recherche en Anatomie Clinique, Geneva, Switzerland.
出版信息
AJNR Am J Neuroradiol. 2004 Jan;25(1):112-20.
BACKGROUND AND PURPOSE
The termination of the superficial middle cerebral vein is classically assimilated to the sphenoid portion of the sphenoparietal sinus. This notion has, however, been challenged in a sometimes confusing literature. The purpose of the present study was to evaluate the actual anatomic relationship existing between the sphenoparietal sinus and the superficial middle cerebral vein.
METHODS
The cranial venous system of 15 nonfixed human specimens was evaluated by the corrosion cast technique (12 cases) and by classic anatomic dissection (three cases). Angiographic correlation was provided by use of the digital subtraction technique.
RESULTS
The parietal portion of the sphenoparietal sinus was found to correspond to the parietal portion of the anterior branch of the middle meningeal veins. The sphenoid portion of the sphenoparietal sinus was found to be an independent venous sinus coursing under the lesser sphenoid wing, the sinus of the lesser sphenoid wing, which was connected medially to the cavernous sinus and laterally to the anterior middle meningeal veins. The superficial middle cerebral vein drained into a paracavernous sinus, a laterocavernous sinus, or a cavernous sinus but was never connected to the sphenoparietal sinus. All these venous structures were demonstrated angiographically.
CONCLUSION
The sphenoparietal sinus corresponds to the artificial combination of two venous structures, the parietal portion of the anterior branch of the middle meningeal veins and a dural channel located under the lesser sphenoid wing, the sinus of the lesser sphenoid wing. The classic notion that the superficial middle cerebral vein drains into or is partially equivalent to the sphenoparietal sinus is erroneous. Our study showed these structures to be independent of each other; we found no instance in which the superficial middle cerebral vein was connected to the anterior branch of the middle meningeal veins or the sinus of the lesser sphenoid wing. The clinical implications of these anatomic findings are discussed in relation to dural arteriovenous fistulas in the region of the lesser sphenoid wing.
背景与目的
大脑中浅静脉的终末段传统上被认为与蝶顶窦的蝶骨部分相连。然而，这一观点在一些令人困惑的文献中受到了挑战。本研究的目的是评估蝶顶窦与大脑中浅静脉之间实际存在的解剖关系。
方法
采用铸型腐蚀技术（12例）和经典解剖方法（3例）对15例未固定的人体标本的颅静脉系统进行评估。通过数字减影技术进行血管造影相关性研究。
结果
发现蝶顶窦的顶叶部分与脑膜中静脉前支的顶叶部分相对应。蝶顶窦的蝶骨部分是一个独立的静脉窦，走行于蝶骨小翼下方，即蝶骨小翼窦，其内侧与海绵窦相连，外侧与脑膜中静脉前支相连。大脑中浅静脉汇入海绵窦旁窦、海绵窦外侧窦或海绵窦，但从未与蝶顶窦相连。所有这些静脉结构在血管造影中均有显示。
结论
蝶顶窦相当于两个静脉结构的人为组合，即脑膜中静脉前支的顶叶部分和位于蝶骨小翼下方的硬脑膜通道，即蝶骨小翼窦。大脑中浅静脉汇入或部分等同于蝶顶窦这一传统观念是错误的。我们的研究表明这些结构相互独立；我们未发现大脑中浅静脉与脑膜中静脉前支或蝶骨小翼窦相连的情况。结合蝶骨小翼区域的硬脑膜动静脉瘘讨论了这些解剖学发现的临床意义。
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