Georgountzos Georgios, Triantafyllou George, Mavrovounis Georgios, Piagkou Maria, Stranjalis George, Kalamatianos Theodosis
Department of Neurosurgery, General Hospital of Nikaia 'Agios Panteleimon', 18454, Athens, Greece.
Department of Neurosurgery, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Surg Radiol Anat. 2024 Dec 12;47(1):29. doi: 10.1007/s00276-024-03532-5.
The paracentral lobule artery (PLA) is a typically present branch of the distal anterior cerebral artery (ACA), irrigating the homonymous lobule. The PLA origin is either a pericallosal portion of the ACA or a prominent branch of the ACA termed callosomarginal (CMA). In addition to the paracentral lobule, the PLA irrigates the cingulate gyrus in the medial hemispheric surface, and the superior portion of the precentral and postcentral gyri in the lateral hemispheric surface. The present cadaveric case series aimed at establishing previously unreported morphometric estimates of the PLA, including its length according to its site of origin, its supplying branches according to its distribution area, as well as its anastomoses.
Seventeen colored latex-injected cadaveric heads were studied with a surgical microscope and microsurgical instruments.
The PLA was invariably present and most commonly originated from the A4 (n = 15 hemispheres, 50%) segment of the ACA. Other PLA origins were the CMA (n = 10, 30%), the A3 (n = 5, 16.7%) and the A5 (n = 1, 3.3%) segments. When the PLA originated from the A4, its mean (SD) overall length was 7.6 (17.9) mm and its mean (SD) diameter was 0.88 (0.26) mm. The PLA supplied the paracentral lobule, cingulate gyrus and post central gyrus with a mean (SD) of 28.07 (13.4), 8.53 (4.27), 5.92 (4.4) branches respectively and the precentral gyrus with a median [IQR] of 2 [0-6] branches. The most common anastomoses of the PLA in the medial and the lateral hemispheric surface involved the ipsilateral posterior internal frontal artery and the branches of the middle cerebral artery, respectively. There were no significant differences between sexes or hemispheric sides for the anatomical features of the artery analyzed.
The present study established previously unreported morphometric estimates for the PLA by considering all possible PLA variant origins and morphological variants. Given that variable pathologies have been previously detected in the areas supplied by the PLA, a better understanding of its anatomy can aid surgical planning and approaches.
中央旁小叶动脉（PLA）是大脑前动脉（ACA）远端典型的分支，供应同名小叶。PLA的起源要么是ACA的胼周部分，要么是ACA的一个显著分支，称为胼缘动脉（CMA）。除中央旁小叶外，PLA还供应大脑半球内侧面的扣带回，以及大脑半球外侧面中央前回和中央后回的上部。本尸体病例系列旨在建立此前未报道的PLA形态学测量数据，包括根据其起源部位的长度、根据其分布区域的供血分支以及其吻合情况。
使用手术显微镜和显微外科器械对17个注入彩色乳胶的尸体头部进行研究。
PLA总是存在，最常见的起源是ACA的A4段（n = 15个半球，50%）。PLA的其他起源是CMA（n = 10，30%）、A3段（n = 5，16.7%）和A5段（n = 1，3.3%）。当PLA起源于A4时，其平均（标准差）全长为7.6（17.9）mm，平均（标准差）直径为0.88（0.26）mm。PLA分别向中央旁小叶、扣带回和中央后回供血，平均（标准差）分支数为28.07（13.4）、8.53（4.27）、5.92（4.4）支，向中央前回供血的分支数中位数[四分位间距]为2[0 - 6]支。PLA在大脑半球内侧面和外侧面最常见的吻合分别涉及同侧额内后动脉和大脑中动脉的分支。所分析动脉的解剖特征在性别或半球侧别之间没有显著差异。
本研究通过考虑PLA所有可能的变异起源和形态变异，建立了此前未报道的PLA形态学测量数据。鉴于此前在PLA供血区域检测到多种病变，更好地了解其解剖结构有助于手术规划和手术入路。
