Emmi Aron, Porzionato Andrea, Contran Martina, De Rose Enrico, Macchi Veronica, De Caro Raffaele
Department of Neuroscience, Institute of Human Anatomy, University of Padua, Padua, Italy.
Front Neuroanat. 2021 Apr 16;15:663399. doi: 10.3389/fnana.2021.663399. eCollection 2021.
The Vagal Trigone, often referred to as Ala Cinerea, is a triangular-shaped area of the floor of the fourth ventricle that is strictly involved in the network of chardiochronotropic, baroceptive, respiratory, and gastrointestinal control systems of the medulla oblongata. While it is frequently identified as the superficial landmark for the underlying Dorsal Motor Nucleus of the Vagus, this correspondence is not univocal in anatomical literature and is often oversimplified in neuroanatomy textbooks and neurosurgical atlases. As the structure represents an important landmark for neurosurgical procedures involving the floor of the fourth ventricle, accurate morphological characterization is required to avoid unwanted side effects (e.g., bradychardia, hypertension) during neuorphysiological monitoring and cranial nerve nuclei stimulation in intraoperative settings. The aim of this study was to address the anatomo-topographical relationships of the Vagal Trigone with the underlying nuclei. For this purpose, we have conducted an anatomo-microscopical examination of serial sections deriving from 54 Human Brainstems followed by 3D reconstruction and rendering of the specimens. Our findings indicate that the Vagal Trigone corresponds only partially with the Dorsal Motor Nucleus of the Vagus, while most of its axial profile is occupied by the dorsal regions of the Solitary Tract Nucleus. Furthermore, basing on literature and our findings we speculate that the neuroblasts of the Dorsal Motor Nucleus of the Vagus undergo neurobiotaxic migration induced by the neuroblasts of the dorsolaterally located solitary tract nucleus, giving rise to the Ala Cinerea, a topographically defined area for parasympathetic visceral control.
迷走神经三角，常被称为灰翼，是第四脑室底部的一个三角形区域，它严格参与延髓的心脏变时性、压力感受性、呼吸和胃肠控制系统网络。虽然它常被视为其下方迷走神经背核的表面标志，但这种对应关系在解剖学文献中并非唯一，且在神经解剖学教科书和神经外科图谱中常被过度简化。由于该结构是涉及第四脑室底部的神经外科手术的重要标志，因此需要准确的形态学特征描述，以避免在术中神经生理监测和颅神经核刺激期间出现不必要的副作用（如心动过缓、高血压）。本研究的目的是探讨迷走神经三角与下方核团的解剖学拓扑关系。为此，我们对54个人脑干部位的连续切片进行了解剖显微镜检查，随后对标本进行了三维重建和渲染。我们的研究结果表明，迷走神经三角仅部分对应于迷走神经背核，而其大部分轴向轮廓被孤束核的背侧区域占据。此外，基于文献和我们的研究结果，我们推测迷走神经背核的神经母细胞经历了由位于背外侧的孤束核神经母细胞诱导的神经生物趋化性迁移，从而形成了灰翼，这是一个用于副交感神经内脏控制的地形学定义区域。
