Nelson M D, Gonzalez-Gomez I, Gilles F H
Department of Radiology-81, University of Southern California School of Medicine, Los Angeles 90027.
AJNR Am J Neuroradiol. 1991 Mar-Apr;12(2):215-22.
Our study traced the vascular development of the fetal telencephalon in the last two trimesters of gestation and the first 15 years of life in 60 fetal and childhood brains. We filled the macro- and microvascular beds with Microfil and made stereoscopic observations of cleared 0.5- to 1.0-cm-thick sections. Separately, we identified developing vascular structures histologically. In our youngest specimen (16-weeks gestation), transcerebral channels with walls consisting of a single layer of endothelium and varying in diameter from 10 to 50 microns originated from leptomeningeal arteries and veins at right angles to the surface and passed through the cortical plate (future cortex). They branched at varying depths within the mantle and germinal matrix surrounding the lateral ventricles. At deeper levels the channels freely anastomosed with each other. A cortical microvascular network did not appear until 22 to 24 weeks. The new endothelial channels were derived from leptomeningeal vessels and from larger transcerebral channels. Most regions of isocortex developed a microvascular plexus simultaneously, regardless of degree of maturation. Striatal channels matured earlier than extrastriatal channels, having developed a muscularis to within 100 microns of the ganglionic eminence by 22- to 24-weeks gestation. Maturation of the vascular walls of extrastriatal channels into proper arteries and veins occurred during the first postnatal year. Anastomotic channels were present throughout the leptomeningeal, striatal, and extrastriatal regions in all of our specimens from 16 weeks gestation to 15 years old. Our study does not support the existence of ventriculofugal arteries and deep white matter arterial border zones in the human fetus and neonate, which have been postulated to be the basis of "periventricular" leukomalacia.
我们的研究追踪了60个胎儿和儿童大脑在妊娠最后两个阶段以及生命最初15年中胎儿端脑的血管发育情况。我们用微丝灌注大脑的大、微血管床,并对0.5至1.0厘米厚的透明切片进行立体观察。另外,我们从组织学角度识别发育中的血管结构。在我们最年幼的标本(妊娠16周)中,经脑通道的壁由单层内皮细胞构成,直径从10至50微米不等,这些通道从软脑膜动脉和静脉以与表面成直角的方向发出,穿过皮质板(未来的皮质)。它们在围绕侧脑室的套层和生发基质内的不同深度处分支。在更深的层面,这些通道相互自由吻合。直到22至24周才出现皮质微血管网络。新的内皮通道源自软脑膜血管和较大的经脑通道。无论成熟程度如何,等皮质的大多数区域同时发育出微血管丛。纹状体通道比纹状体以外的通道成熟得更早,在妊娠22至24周时,其肌层已发育到距神经节隆起100微米以内。纹状体以外通道的血管壁在出生后第一年成熟为正常的动脉和静脉。在我们所有从妊娠16周直至15岁的标本中,软脑膜、纹状体和纹状体以外区域均存在吻合通道。我们的研究不支持人类胎儿和新生儿中存在脑室离心动脉和深部白质动脉边界区的观点,而这些结构被认为是“脑室周围”白质软化的基础。