Horiuchi Tetsuyoshi, Tanaka Yuichiro, Kusano Yoshikazu, Yako Takehiro, Sasaki Tetsuo, Hongo Kazuhiro
Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
J Neurosurg. 2009 Jul;111(1):119-23. doi: 10.3171/2008.11.JNS08766.
The ophthalmic artery (OphA) usually arises from the intradural internal carotid artery (ICA), and the extradural origin has also been known. However, the interdural origin is extremely rare. The purpose of this paper was to clarify the origin of the OphA in patients with a paraclinoid aneurysm in the ICA based on intraoperative findings.
The authors retrospectively examined 156 patients who underwent direct surgical treatment for 166 paraclinoid aneurysms during a 17-year period. Based on intraoperative findings, 119 ophthalmic arteries were analyzed with respect to their origins.
The OphA originated from the intradural ICA on 102 sides (85.7%), extradural on 9 (7.6%), and interdural on 8 (6.7%). Although the extradural origin might be recognized preoperatively, it was difficult to distinguish the interdural origin of the OphA from the intradural one.
The incidence of the interdural origin was 6.7% and was not as rare as the authors expected. Neurosurgeons should know the possible existence of the interdural origin of the OphA to section the medial side of the dural ring.
眼动脉(OphA)通常起源于硬膜内颈内动脉(ICA),硬膜外起源也已为人所知。然而,硬膜间起源极为罕见。本文旨在根据术中发现阐明ICA床突旁动脉瘤患者眼动脉的起源。
作者回顾性研究了17年间接受166例床突旁动脉瘤直接手术治疗的156例患者。根据术中发现,对119条眼动脉的起源进行了分析。
眼动脉起源于硬膜内ICA的有102侧(85.7%),硬膜外起源的有9侧(7.6%),硬膜间起源的有8侧(6.7%)。虽然硬膜外起源术前可能被识别,但很难将眼动脉的硬膜间起源与硬膜内起源区分开来。
硬膜间起源的发生率为6.7%,并不像作者预期的那么罕见。神经外科医生应了解眼动脉硬膜间起源的可能存在,以便切开硬膜环内侧。