Peltier Johann, Fichten Anthony, Havet Eric, Foulon Pascal, Page Cyril, Le Gars Daniel
Laboratoire d'Anatomie et d'Organogenèse, Université de Picardie Jules Verne, Amiens, France.
Surg Radiol Anat. 2010 Dec;32(10):919-25. doi: 10.1007/s00276-010-0655-z. Epub 2010 Apr 16.
In the current literature, there is a lack of detailed map of the origin, course and relationships of the medial tentorial artery (MTA) of Bernasconi-Cassinari often implicated in various diseases such as dural arteriovenous fistulas of the cranial base, stenotic lesions of the ICA, saccular infraclinoid intracavernous aneurysms and tentorial meningiomas.
Using a colored silicone mix preparation, ten cranial bases were examined using ×3 to ×40 magnification of the surgical microscope.
The MTA arose as a single branch in 95% of cases from the MHT at the level of the C4 segment of the internal carotid artery. The average length of the MTA was 21.7 mm (range 20.0-23.4 mm). The average diameter of the MTA was 0.53 mm (range 0.49-0.60 mm).The MTA passed just below the lower dural ring detached from the lower margin of the anterior clinoid process. During its course, the MTA drop over the intracavernous segment of the abducens nerve twisted at its exit from the Dorello's canal and overlay the trochlear into the thickness of the free margin of the tentorium cerebelli. Vascular relationships of the MTA were venous trabeculation of the cavernous sinus, basilar plexus and branches of the inferolateral trunk. The MTA sent two terminal branches: one medial rectilinear, which pursued the initial dorsal course, and the other shorter with a lateral course, which disappeared into the lateral wall of the cavernous sinus. The medial branch of the MTA curved laterally, ramifying within the free edge of the tentorium cerebelli and anastomosing along the base of the dorsal part of the falx.
The implications of these anatomic findings for surgery or endovascular procedure are reviewed and discussed.
在当前文献中，缺乏对伯纳斯coni - 卡西纳里小脑幕内侧动脉（MTA）的起源、走行及其毗邻关系的详细图谱，该动脉常与多种疾病相关，如颅底硬脑膜动静脉瘘、颈内动脉狭窄性病变、鞍旁海绵窦内囊状动脉瘤和小脑幕脑膜瘤。
使用彩色硅酮混合物制剂，在手术显微镜放大3倍至40倍的情况下检查了10个颅底。
95%的病例中，MTA作为单一分支起源于颈内动脉C4段水平的脑膜垂体干。MTA的平均长度为21.7毫米（范围为20.0 - 23.4毫米）。MTA的平均直径为0.53毫米（范围为0.49 - 0.60毫米）。MTA从与前床突下缘分离的硬脑膜下环下方经过。在其走行过程中，MTA在展神经海绵窦段下方经过，展神经在从多雷洛管穿出时扭曲，并覆盖滑车神经进入小脑幕游离缘的厚度内。MTA的血管毗邻关系包括海绵窦的静脉小梁、基底丛和下外侧干分支。MTA发出两个终末分支：一个为内侧直线分支，沿初始背侧走行，另一个较短，走行于外侧，消失于海绵窦外侧壁。MTA的内侧分支向外侧弯曲，在小脑幕游离缘内分支，并沿大脑镰背侧部分的底部吻合。
对这些解剖学发现对手术或血管内操作的意义进行了回顾和讨论。
