UMR 1253, ibrain, Université de Tours, Inserm, Tours, France.
CHRU de Tours, Tours, France.
J Anat. 2021 Jul;239(1):1-11. doi: 10.1111/joa.13413. Epub 2021 Feb 18.
Supratentorial sensory perception, including pain, is subserved by the trigeminal nerve, in particular, by the branches of its ophthalmic division, which provide an extensive innervation of the dura mater and of the major brain blood vessels. In addition, contrary to previous assumptions, studies on awake patients during surgery have demonstrated that the mechanical stimulation of the pia mater and small cerebral vessels can also produce pain. The trigeminovascular system, located at the interface between the nervous and vascular systems, is therefore perfectly positioned to detect sensory inputs and influence blood flow regulation. Despite the fact that it remains only partially understood, the trigeminovascular system is most probably involved in several pathologies, including very frequent ones such as migraine, or other severe conditions, such as subarachnoid haemorrhage. The incomplete knowledge about the exact roles of the trigeminal system in headache, blood flow regulation, blood barrier permeability and trigemino-cardiac reflex warrants for an increased investigation of the anatomy and physiology of the trigeminal system. This translational review aims at presenting comprehensive information about the dural and brain afferents of the trigeminovascular system, in order to improve the understanding of trigeminal cranial sensory perception and to spark a new field of exploration for headache and other brain diseases.
颅上感觉感知,包括疼痛,由三叉神经支配,特别是由其眼分支提供脑膜和大脑主要血管的广泛神经支配。此外,与之前的假设相反,对手术中清醒患者的研究表明,软脑膜和小脑血管的机械刺激也会产生疼痛。三叉血管系统位于神经和血管系统的交界处,因此非常适合检测感觉输入并影响血流调节。尽管三叉血管系统的机制仍不完全清楚,但它很可能与多种疾病有关,包括偏头痛等常见疾病,或蛛网膜下腔出血等其他严重疾病。由于对三叉神经系统在头痛、血流调节、血脑屏障通透性和三叉心动反射中的确切作用了解甚少,因此需要进一步研究三叉神经系统的解剖和生理学。本综述旨在提供关于三叉血管系统脑膜和脑传入的全面信息,以提高对三叉颅感觉感知的理解,并为头痛和其他脑部疾病开辟新的探索领域。