Umansky F, Gomes F B, Dujovny M, Diaz F G, Ausman J I, Mirchandani H G, Berman S K
J Neurosurg. 1985 Feb;62(2):261-8. doi: 10.3171/jns.1985.62.2.0261.
The perforating branches (PFB's) of the middle cerebral artery (MCA) were studied in 34 unfixed brain hemispheres which were injected with a polyester resin and dissected under the operating microscope. Five hundred and eight vessels were identified and their site of origin, branching pattern, outer diameter (OD), and length recorded. Four hundred and two PFB's (79%) originated from the main trunk of the MCA before its division; the remaining 106 vessels (21%) had their origin from branches of the MCA as follows: superior trunk, 43 vessels (8.5%); inferior trunk, 30 vessels (6%); middle trunk, four vessels (0.8%); early temporal branch, 27 vessels (5.3%); and early frontal branch, two vessels (0.4%). The number of PFB's in each hemisphere varied from five to 29 (mean 14.9 +/- 0.7 vessels). The great majority of PFB's (96%) originated along the proximal 17 mm of the MCA. The PFB's arising in the first 10 mm had a mean OD of 0.35 +/- 0.01 mm and a mean length of 9.25 +/- 0.19 mm, and those arising from the second 10 mm had a mean OD of 0.47 +/- 0.02 mm and a mean length of 16.67 +/- 1.4 mm. A clear distinction between a medial and lateral group of PFB's was present in only 14 hemispheres (41%). In nine hemispheres (26%), perforating vessels from the anterior cerebral artery (A1 segment) and from the recurrent artery of Heubner replaced the medial group of PFB's of the MCA. In one case this group originated in an accessory MCA. In three hemispheres (9%) a small anastomosis (OD 0.2 mm) was seen between a PFB of the recurrent artery of Heubner and one of the MCA. From a total of 508 PFB's, 255 vessels (50%) originated as single vessels, while 253 vessels (50%) originated as branches of common stems. The OD of the single vessels ranged from 0.1 mm to 1.1 mm (mean 0.39 +/- 0.02 mm), and the length from 3 to 20 mm (mean 10.8 +/- 0.2 mm). The common stems ranged in OD from 0.6 to 1.8 mm (mean 0.87 +/- 0.04 mm), and in length from 1 to 15 mm (mean 4.1 +/- 0.4 mm). The clinical application of these anatomical data to the management of aneurysms and arteriovenous malformations of the MCA, and in the field of interventional neuroradiology is described. The most frequent pathological entities involving the perforating vessels are also discussed.
在34个未固定的脑半球中对大脑中动脉（MCA）的穿支（PFB's）进行了研究，这些脑半球用聚酯树脂灌注并在手术显微镜下解剖。共识别出508条血管，并记录了它们的起源部位、分支模式、外径（OD）和长度。402条PFB's（79%）起源于MCA主干分叉前；其余106条血管（21%）起源于MCA的分支，如下：上干43条血管（8.5%）；下干30条血管（6%）；中干4条血管（0.8%）；早期颞支27条血管（5.3%）；早期额支2条血管（0.4%）。每个半球中PFB's的数量从5条到29条不等（平均14.9±0.7条血管）。绝大多数PFB's（96%）起源于MCA近端17mm范围内。在前10mm内发出的PFB's平均外径为0.35±0.01mm，平均长度为9.25±0.19mm，而从第二个10mm内发出的PFB's平均外径为0.47±0.02mm，平均长度为16.67±1.4mm。只有14个半球（41%）中PFB's的内侧组和外侧组有明显区别。在9个半球（26%）中，大脑前动脉（A1段）和Heubner回返动脉的穿支血管取代了MCA的内侧组PFB's。在1例中，该组起源于副MCA。在3个半球（9%）中，Heubner回返动脉的1条PFB's与1条MCA之间可见一个小的吻合（外径0.2mm）。在总共508条PFB's中，255条血管（50%）以单支形式起源，而253条血管（50%）以共同干的分支形式起源。单支血管的外径范围为0.1mm至1.1mm（平均0.39±0.02mm），长度范围为3至20mm（平均10.8±0.2mm）。共同干的外径范围为0.6至1.8mm（平均0.87±0.04mm），长度范围为1至15mm（平均4.1±0.4mm）。描述了这些解剖学数据在MCA动脉瘤和动静脉畸形治疗以及介入神经放射学领域的临床应用。还讨论了涉及穿支血管的最常见病理实体。
