Lee Shin-Hyo, Hwang Seung-Jun, Koh Ki-Seok, Song Wu-Chul, Han Sang-Don
Department of Anatomy, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, South Korea.
Department of Anatomy, Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Front Neuroanat. 2017 Dec 19;11:127. doi: 10.3389/fnana.2017.00127. eCollection 2017.
The trigeminovascular system within the cranial dura mater is a possible cause of headaches. The aim of this study is to investigate macroscopically dural innervation around the middle meningeal artery (MMA) in the middle cranial fossa. Forty-four sides of the cranial dura overlying the skull base obtained from 24 human cadavers were stained using Sihler's method. Overall, the nervus spinosus (NS) from either the maxillary or mandibular trigeminal divisions ran along the lateral wall of the middle meningeal vein rather than that of the MMA. Distinct bundles of the NS running along the course of the frontal branches of the MMA were present in 81.8% of cases ( = 36). Others did not form dominant nerve bundles, instead giving off free nerve endings along the course of the MMA or dural connective tissue. The distribution of these nerve endings was similar to that of the course of the frontal, parietal and petrosal branches of the MMA (11.4%). The others were not restricted to a perivascular plexus, crossing the dural connective tissues far from the MMA (6.8%). These findings indicate that the NS generally travels alongside the course of the frontal branches of the MMA and terminates in the vicinity of the pterion.
颅硬膜内的三叉神经血管系统是头痛的一个可能原因。本研究的目的是宏观研究颅中窝脑膜中动脉（MMA）周围的硬脑膜神经支配。使用西勒氏法对取自24具人类尸体的覆盖颅底的44侧颅硬膜进行染色。总体而言，来自上颌或下颌三叉神经分支的棘神经（NS）沿脑膜中静脉的侧壁走行，而非沿MMA的侧壁走行。81.8%的病例（n = 36）中存在沿MMA额支走行的明显NS束。其他情况则未形成优势神经束，而是沿MMA或硬脑膜结缔组织发出游离神经末梢。这些神经末梢的分布与MMA额支、顶支和岩支的走行分布相似（11.4%）。其他情况并不局限于血管周围丛，而是穿过远离MMA的硬脑膜结缔组织（6.8%）。这些发现表明，NS通常沿MMA额支走行并在翼点附近终止。
