Park Sukh Que, Bae Hack-Gun, Yoon Seok-Mann, Shim Jai-Joon, Yun Il-Gyu, Choi Soon-Kwan
Department of Neurosurgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Science, Seoul, Korea.
J Korean Neurosurg Soc. 2010 Jan;47(1):36-41. doi: 10.3340/jkns.2010.47.1.36. Epub 2010 Jan 31.
The aim of this study was to investigate the morphological characteristics of the thalamoperforating arteries that arise from the P1 segment of the posterior cerebral artery.
Thalamoperforating arteries located in the interpeduncular fossa were dissected in 26 formalin-fixed human cadaver brains. We investigated the origin site of thalamoperforating arteries from the P1 segment, number and diameter, and variations in their origin.
Thalamoperforating arteries arose from the superior, posterior or posterosuperior surfaces of the P1 segment at the mean 1.93 mm (range, 0.41-4.71 mm) distance from the basilar apex and entered the brain through the posterior perforated substance. The average number was 3.6 (range 1-8) and mean diameter was 0.70 mm (range 0.24-1.18 mm). Thalamoperforating arteries could be classified into five different types according to their origin at the P1 segment : Type I (bilateral multiple), 38.5%; Type II (unilateral single, unilateral multiple), 26.9%; Type III (bilateral single), 19.2%; Type IV (unilateral single), 11.5%; Type V (unilateral multiple), 3.8%. In 15.4% of all specimens, thalamoperforating arteries arose from the only one side of P1 segment and were not noted in the other side. In such cases, the branches arising from the one side of P1 segment supplied the opposite side.
Variations in the origin of the thalamoperforating arteries should be keep in mind to perform the surgical clipping, endovascular treatment or operation involving the interpeduncular fossa. In particular, unilateral single branch seems to be very risky and significant for surgical technique or endovascular treatment.
本研究旨在探讨发自大脑后动脉P1段的丘脑穿通动脉的形态学特征。
在26例经福尔马林固定的人脑尸体上解剖位于脚间窝的丘脑穿通动脉。我们研究了丘脑穿通动脉从P1段的起源部位、数量和直径，以及它们起源的变异情况。
丘脑穿通动脉起源于P1段的上表面、后表面或后上表面，距基底动脉尖平均距离为1.93 mm（范围0.41 - 4.71 mm），并通过后穿质进入脑内。平均数量为3.6条（范围1 - 8条），平均直径为0.70 mm（范围0.24 - 1.18 mm）。根据丘脑穿通动脉在P1段的起源可分为五种不同类型：I型（双侧多发），38.5%；II型（单侧单发、单侧多发），26.9%；III型（双侧单发），19.2%；IV型（单侧单发），11.5%；V型（单侧多发），3.8%。在所有标本的15.4%中，丘脑穿通动脉仅起源于P1段的一侧，另一侧未发现。在这种情况下，从P1段一侧发出的分支供应对侧。
在进行涉及脚间窝的手术夹闭、血管内治疗或手术时，应牢记丘脑穿通动脉起源的变异情况。特别是，单侧单分支在手术技术或血管内治疗方面似乎风险很大且意义重大。
