Salaud Céline, Decante Cyrille, Ploteau Stéphane, Hamel Antoine
Laboratoire d'Anatomie, Faculté de Médecine, Université de Nantes, 1, rue Gaston Veil, 44035, Nantes Cedex, France.
Neurochirurgie Neurotraumatologie, Centre Hospitalo Universitaire de Nantes, 1 place Alexis Ricordeau, 44000, Nantes Cedex 1, France.
Surg Radiol Anat. 2020 Feb;42(2):179-187. doi: 10.1007/s00276-019-02320-w. Epub 2019 Sep 5.
In the literature, there is a lack of complete description of dural arteries of the dorsoclival area with contradictory data. However, dorsoclival area is a site of tumors and vascular malformation or the skull base. That is why, the knowledge of dural arteries is very important.
Using a colored silicone mix preparation, fifteen sides of eight cranial bases were studied using 4-20× magnification of the surgical microscope.
Dorsoclival area is supplying by three arterial complexes, internal carotid artery complex with always the dorsal meningeal artery for the superior two-third of the clivus, medial clival artery for the dorsum sellae, the external carotid artery complex with the hypoglossal and jugular branches of the ascending pharyngeal artery for the inferior one-third of the clivus, and the vertebral artery complex with the anterior meningeal artery for the most inferior part of the clivus and the anterior edge of the foramen magnum. Moreover, there are many anastomoses between those three arterial complexes at this area.
Dural arterial supply of the dorsoclival area is very opulent. Its knowledge is important for surgical approaches and endovascular procedures.
文献中对斜坡背侧区域硬脑膜动脉缺乏完整描述且数据相互矛盾。然而,斜坡背侧区域是肿瘤、血管畸形的好发部位或位于颅底。因此,了解硬脑膜动脉非常重要。
使用彩色硅酮混合物制剂,在手术显微镜4 - 20倍放大倍数下对8个颅底的15个侧面进行研究。
斜坡背侧区域由三个动脉复合体供血,颈内动脉复合体,其发出的脑膜背动脉供应斜坡上三分之二区域,斜坡内侧动脉供应鞍背;颈外动脉复合体,其发出的咽升动脉舌下支和颈静脉支供应斜坡下三分之一区域;椎动脉复合体,其发出的脑膜前动脉供应斜坡最下部及枕骨大孔前缘。此外,这三个动脉复合体在该区域有许多吻合支。
斜坡背侧区域的硬脑膜动脉血供非常丰富。了解其血供情况对外科手术入路和血管内介入操作具有重要意义。