Muralimohan S, Pande Anil, Vasudevan M C, Ramamurthi Ravi
Department of Neurosurgery, Post Graduate Institute of Neurological Surgery, ALNC, VHS Hospital, Taramani, Chennai-600 113, India.
Neurol India. 2009 Jul-Aug;57(4):447-52. doi: 10.4103/0028-3886.55610.
To study the course, relationships, branches and possible anomalies of the vertebral artery in the suboccipital region in adult Indian cadavers.
Twenty-one suboccipital segment vertebral artery specimens from embalmed, Indian adult cadavers were dissected and studied. Dissection was performed using microsurgical instruments and was carried out from the skin up to the vertebral artery in layers. The course, relationships and the branches of the vertebral artery were studied and measurements were taken using Vernier calipers. The readings obtained were corroborated with the measurements derived from the digital images using a computer.
All the vertebral arteries had a tortuous course and were covered with rich venous plexuses. None of the specimens had an anomalous course. The artery was divided into a vertical segment (Vv) between C2 and C1 vertebra and a horizontal segment (Vh) from the C1 transverse foramina to its dural entry. The mean diameter of the artery was 4.8 mm. The shortest distance of Vv segment from the dural tube was 16.1 mm, and the distance from the C2 ganglion was 7.2 mm. The average length of the Vv segment was 15 mm and the average length of the Vh segment was 35.6 mm. The average of the shortest distance between the vertebral artery and the midline was 13.4 mm.
The vertebral artery has a tortuous course and is prone to accidental iatrogenic injury, which can result in devastating neurological sequelae depending on contralateral vertebral artery flow. A thorough anatomical knowledge of this segment is essential for the surgeon who intends to operate in this area.
研究成年印度尸体枕下区域椎动脉的走行、毗邻关系、分支及可能存在的变异情况。
解剖并研究21例来自经防腐处理的成年印度尸体的枕下节段椎动脉标本。使用显微外科器械进行解剖，从皮肤逐层解剖至椎动脉。研究椎动脉的走行、毗邻关系和分支，并用游标卡尺进行测量。所获得的读数与利用计算机从数字图像得出的测量值进行核对。
所有椎动脉走行迂曲，且被丰富的静脉丛覆盖。所有标本均无走行变异。椎动脉在C2和C1椎体之间分为垂直段（Vv），从C1横突孔至硬脑膜入口处为水平段（Vh）。椎动脉平均直径为4.8毫米。Vv段距硬脊膜管的最短距离为16.1毫米，距C2神经节的距离为7.2毫米。Vv段平均长度为15毫米，Vh段平均长度为35.6毫米。椎动脉与中线之间最短距离的平均值为13.4毫米。
椎动脉走行迂曲，易于发生医源性意外损伤，根据对侧椎动脉血流情况，这可能导致严重的神经后遗症。对于打算在此区域进行手术的外科医生而言，全面了解该节段的解剖知识至关重要。
