Microneurosurgery Laboratory, Beneficência Portuguesa Hospital and the Institute of Neurological Sciences, São Paulo, Brazil.
World Neurosurg. 2011 Feb;75(2):233-57. doi: 10.1016/j.wneu.2010.10.053.
To describe the microsurgical anatomy, branches, and anatomic relationships of the posterior cerebral artery (PCA) represented in three-dimensional images.
Seventy hemispheres of 35 brain specimens were studied. They were previously injected with red silicone and fixed in 10% formalin for at least 40 days. Four of the studied specimens were frozen at -10° to -15 °C for 14 days, and additional dissection was done with the Klingler's fiber dissection technique at ×6 to ×40 magnification. Each segment of the artery was measured and photographed to obtain three-dimensional stereoscopic images.
The PCA origin was in the interpeduncular cistern at the pontomesencephalic junction level in 23 specimens (65.7%). The PCA was divided into four segments: P1 extends from the PCA origin to its junction with the posterior communicating artery with an average length of 7.7 mm; P2 was divided into an anterior and posterior segment. The P2A segment begins at the posterior communicating artery and ends at the most lateral aspect of the cerebral peduncle, with an average length of 23.6 mm, and the P2P segment extends from the most lateral aspect of the cerebral peduncle to the posterior edge of the lateral surface of the midbrain, with an average length of 16.4 mm; P3 extends from the posterior edge of the lateral surface of the midbrain and ends at the origin of the parieto-occipital sulcus along the calcarine fissure, with an average length of 19.8 mm; and the P4 segment corresponds to the parts of the PCA that run along or inside both the parieto-occipital sulcus and the distal part of the calcarine fissure.
To standardize the neurosurgical practice and knowledge, surgical anatomic classifications should be used uniformly and further modified according to the neurosurgical experience gathered. The PCA classification proposed intends to correlate its anatomic segments with their required microneurosurgical approaches.
描述在三维图像中表现的大脑后动脉（PCA）的显微解剖结构、分支和解剖关系。
研究了 35 个脑标本的 70 个半脑。它们之前用红色硅酮注射并在 10％甲醛中固定至少 40 天。其中 4 个研究标本在-10°至-15°C 下冷冻 14 天，并使用 Klingler 纤维解剖技术在×6 至×40 放大倍数下进行额外解剖。测量并拍摄每个动脉段以获得三维立体图像。
23 个标本（65.7％）中 PCA 的起源位于脑桥中脑结合部的脚间池。PCA 分为四个节段：P1 从 PCA 起源延伸至其与后交通动脉的交界处，平均长度为 7.7 毫米；P2 分为前节段和后节段。P2A 段从后交通动脉开始，止于大脑脚最外侧，平均长度为 23.6 毫米，P2P 段从大脑脚最外侧延伸至中脑外侧表面的后缘，平均长度为 16.4 毫米；P3 从中脑外侧表面的后缘延伸至顶枕沟的起点，沿着距状裂延伸，平均长度为 19.8 毫米；P4 段对应于 PCA 的部分，沿顶枕沟和距状裂的远端运行或位于其内部。
为了规范神经外科实践和知识，应统一使用手术解剖分类，并根据积累的神经外科经验进一步修改。所提出的 PCA 分类旨在将其解剖节段与其所需的微创神经外科方法相关联。
