Umansky F, Juarez S M, Dujovny M, Ausman J I, Diaz F G, Gomes F, Mirchandani H G, Ray W J
J Neurosurg. 1984 Sep;61(3):458-67. doi: 10.3171/jns.1984.61.3.0458.
The microvascular anatomy of the proximal segments (M1 and M2) of the middle cerebral artery (MCA) was studied in 70 unfixed brain hemispheres from 35 cadavers. The arteries were injected with a tinted polyester resin and dissected under magnification by microsurgical techniques. The authors studied the outer diameter (OD), length, site of origin, and pattern of branching of the main trunk, secondary trunks, and the initial insular portion of the cortical branches of the MCA. The degree of mobilization of the arteries lying over the insular cortex was also assessed. The main trunk of the MCA, which had an OD of 3 +/- 0.1 mm bilaterally and a length of 15 +/- 1.1 mm in the right hemisphere and 15.7 +/- 1.3 mm in the left hemisphere, could be divided into four groups: Group I: absence of a main division (that is, a single-trunk type of MCA) (in 6% of cases); Group II: bifurcation (64%); Group III: trifurcation (29%); and Group IV: quadrifurcation (1%). The secondary trunks resulting from the division of the main trunk of the MCA had a mean OD ranging from 1.4 to 2.3 mm and a mean length that varied from 12.1 to 14.9 mm. The mean OD of the cortical branches measured near their origin in the main and secondary trunks indicated that the angular artery was the largest vessel, with a mean OD of 1.5 mm on both sides of the brain. The temporopolar artery was the smallest, with a mean OD of 0.8 mm in the right hemisphere and 0.9 mm in the left hemisphere. The authors also describe the patterns of origin of the cortical vessels from the main trunk (early branches) and from the secondary trunks, as well as their branching pattern at the site of origin (single vessels and common stems). These anatomical data indicate that it is possible to perform microvascular reconstructive procedures, such as anastomosis, grafting, and reimplantation of branches in the insular area. The advantages of using unfixed specimens, intravascular injections, and magnification to reproduce in vivo conditions as closely as possible are also discussed.
在35具尸体的70个未固定脑半球中，研究了大脑中动脉（MCA）近端节段（M1和M2）的微血管解剖结构。向动脉内注入带色的聚酯树脂，并通过显微外科技术在放大条件下进行解剖。作者研究了MCA主干、二级分支以及皮质分支起始岛叶部分的外径（OD）、长度、起源部位和分支模式。还评估了位于岛叶皮质上方动脉的可移动程度。MCA主干双侧外径为3±0.1mm，右侧半球长度为15±1.1mm，左侧半球长度为15.7±1.3mm，可分为四组：第一组：无主要分支（即单干型MCA）（6%的病例）；第二组：二分叉（64%）；第三组：三分叉（29%）；第四组：四分叉（1%）。MCA主干分支形成的二级分支平均外径在1.4至2.3mm之间，平均长度在12.1至14.9mm之间。在主干和二级分支起源处附近测量的皮质分支平均外径表明，角动脉是最大的血管，两侧大脑的平均外径均为1.5mm。颞极动脉最小，右侧半球平均外径为0.8mm，左侧半球平均外径为0.9mm。作者还描述了皮质血管从主干（早期分支）和二级分支的起源模式，以及它们在起源部位的分支模式（单支血管和共同干）。这些解剖学数据表明，在岛叶区域进行微血管重建手术，如吻合、移植和分支再植是可行的。还讨论了使用未固定标本、血管内注射和放大以尽可能接近体内条件的优点。
