Department of Neurosurgery, School of Medicine, Bursa Uludag University, Bursa, 16059, Turkey.
Department of Forensic Medicine, School of Medicine, Bursa Uludag University, Bursa, Turkey.
Anat Sci Int. 2021 Mar;96(2):294-300. doi: 10.1007/s12565-020-00595-3. Epub 2021 Jan 5.
The chiasmal and subchiasmal surfaces are of critical importance in connection with the performance of surgical procedures owing to the critical blood supply to these areas. Recently, the perforating arteries providing the blood to the optic nerves and chiasm have gained attention as they significantly affect the morbidity from surgical approaches. Intraoperative preservation of these perforating arteries is considered critical to prevent further visual loss. Thirty autopsy specimens, including the optic apparatus, were examined for their perforating arteries feeding the optic chiasm and optic nerves. The optic nerves and chiasmal surfaces were divided into four zones based on the presence and numbers of perforating arteries as anterior superior-posterior superior surfaces and anterior inferior-posterior inferior surfaces. The superior surface of the optic chiasm was supplied by the A1 segments of the bilateral anterior cerebral arteries and by the perforating arteries originating from the anterior communicating artery. On the other hand, the inferior surface of the optic chiasm was fed by the bilateral posterior communicating arteries and by the supraclinoidal segments of the bilateral carotid arteries. We demonstrated the anatomical involvement of a large number of nourishing arteries in feeding the optic apparatus related to the perforating arteries by classifying them into zones based on the surgical approaches, which has been rarely reported in the literature.
视交叉和视交叉下表面在手术操作中非常重要，因为这些区域的血液供应非常关键。最近，为视神经和视交叉提供血液的穿通动脉引起了人们的关注，因为它们会显著影响手术入路的发病率。术中保护这些穿通动脉被认为是预防进一步视力丧失的关键。检查了 30 个尸检标本，包括视神经器，以研究供应视交叉和视神经的穿通动脉。视神经和视交叉表面根据穿通动脉的存在和数量分为四个区，即前上-后上表面和前下-后下表面。视交叉的上表面由双侧大脑前动脉的 A1 段和发自前交通动脉的穿通动脉供应。另一方面，视交叉的下表面由双侧后交通动脉和双侧颈内动脉的床突上段供应。我们通过根据手术入路将滋养动脉分类到各个区域，展示了与穿通动脉相关的视神经器的大量营养动脉的解剖学参与，这在文献中很少报道。
