Isolan Gustavo, de Oliveira Evandro, Mattos João Paulo
Laboratório de Microcirurgia, Hospital Beneficência Portuguesa de São Paulo, Instituto de Ciências Neurológicas, São Paulo SP, Brazil.
Arq Neuropsiquiatr. 2005 Jun;63(2A):259-64. doi: 10.1590/s0004-282x2005000200012.
The cavernous sinus is a complex compartment situated in both sides of the sella turcica, being its microsurgical anatomy knowledge of fundamental importance when consider to approach surgically. We studied the arterial microanatomy of 24 cavernous sinus at the microsurgical laboratory, considering that in all the internal carotid artery were filled with colored latex. The meningohypophyseal trunk was present in 18 cases (75%) with its origin in intracavernous portion of the internal carotid artery. In relation to the 18 presented cases with meningohypophyseal trunk, 14 (77.7%) had a trifurcate and 4 (23.3%) had a bifurcate pattern. The tentorial artery was present in all. Its origin was observed, arising from the meningohypophyseal trunk in 17 (70.8%) and as an isolated artery in some extension of the intracavernous portion in 7 (29.1%). An accessory tentorial artery was found in one specimen. The dorsal meningeal artery was present in 22 cases (91.6%). Its origin was in the meningohypophyseal trunk in 17 cases (77.2%), arising from internal carotid artery in 4 cases (18.1%) and from inferior hypophyseal artery in one case (4.1%).The inferior hypophyseal artery was present in all cases, having its origin at the meningohypophyseal trunk in 16 cases (66.6%). In the remaining 8 cases (33.3%) the artery was found arising alone from the intracavernous portion also. The artery of the inferior cavernous sinus or inferolateral trunk was present in all cases and had its origin from internal carotid artery in its intracavernous segment. The McConnell's artery was not found in any cavernous sinus.
海绵窦是位于蝶鞍两侧的一个复杂腔隙,在考虑进行手术入路时,对其显微外科解剖知识的了解至关重要。我们在显微外科实验室研究了24个海绵窦的动脉显微解剖结构,所有颈内动脉均用彩色乳胶填充。18例(75%)出现脑膜垂体干,其起源于颈内动脉海绵窦段。在18例出现脑膜垂体干的病例中,14例(77.7%)呈三叉分支模式,4例(23.3%)呈双叉分支模式。所有病例均有小脑幕动脉。观察到其起源,17例(70.8%)起源于脑膜垂体干,7例(29.1%)起源于海绵窦段某一延伸部位的单独动脉。在一个标本中发现一条副小脑幕动脉。22例(91.6%)出现脑膜背侧动脉。其起源于脑膜垂体干的有17例(77.2%),起源于颈内动脉的有4例(18.1%),起源于垂体下动脉的有1例(4.1%)。所有病例均有垂体下动脉,16例(66.6%)起源于脑膜垂体干。其余8例(33.3%)该动脉也单独起源于海绵窦段。所有病例均有海绵窦下动脉或下外侧干,其起源于颈内动脉海绵窦段。在任何海绵窦中均未发现麦康奈尔动脉。