Choi Chan-Young, Han Seong-Rok, Yee Gi-Taek, Lee Chae-Heuck
Department of Neurosurgery, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Korea.
J Korean Neurosurg Soc. 2010 May;47(5):377-80. doi: 10.3340/jkns.2010.47.5.377. Epub 2010 May 31.
The abducens nerve usually travels from the brainstem to the lateral rectus muscle as a single trunk. However, it has been reported that this nerve could split into branches occasionally. We attempted to show the aberrant course of abducens nerve in a specimen with unilateral duplicated abducens nerve and review relevant literatures. The micro-dissections were performed in a head specimen injected with colored latex under the microscope. The abducens nerve was duplicated unilaterally. This nerve emerged from the pontomedullary sulcus as a single trunk and splitted into two branches in the prepontine cistern. These two separate branches were piercing the cerebral dura of the petroclival region respectively. The slender lower branch passed between the petroclinoid and petrosphenoid ligaments and the thick lower one passed under the petrosphenoid ligament. These two branches united just lateral to the ascending segment of internal carotid artery in the cavernous sinus. The fact that there are several types of aberrant abducens nerve is helpful to perform numerous neurosurgical procedures in the petroclival region and cavernous sinus without inadvertent neurovascular injuries.
展神经通常作为一个单一的主干从脑干走行至外直肌。然而,据报道该神经偶尔会分裂成分支。我们试图在一个单侧展神经重复的标本中展示展神经的异常走行并回顾相关文献。在显微镜下对注射了彩色乳胶的头部标本进行显微解剖。展神经单侧重复。该神经作为一个单一主干从脑桥延髓沟发出,在脑桥前池分裂成两个分支。这两个独立的分支分别穿透岩斜区的硬脑膜。较细的下支在岩床韧带和岩蝶韧带之间通过,较粗的下支在岩蝶韧带下方通过。这两个分支在海绵窦内颈内动脉升段的外侧刚好合并。展神经存在多种异常类型这一事实有助于在岩斜区和海绵窦进行众多神经外科手术而不会意外损伤神经血管。