Serizawa T, Saeki N, Fukuda K, Yamaura A
Department of Neurosurgery, Chiba University School of Medicine.
No Shinkei Geka. 1994 May;22(5):447-54.
Microsurgical anatomy of anterior communicating artery (ACoA) and its perforating arteries important for interhemispheric trans-lamina terminalis approach is examined in 25 cadaver brains under magnification using a surgical microscope. ACoA were found in all cases but 60% of those cases had variations such as plexiform ACoA, dimple ACoA, fenestrated ACoA, triple A2 and azygous ACA. In cases with variations such as plexiform ACoA, triple A2 and azygous ACA, it seems difficult to section and divide the ACoA to obtain a better operative field. Perforating arteries of ACoA were noted in all cases. They were classified into the subcallosal artery, hypothalamic artery and chiasmatic artery according to caliber, origin, course and termination. Among these three arteries, subcallosal artery is thought to be an offending artery in memory impairment, character change and psychological abnormalities, because it terminates at the bilateral subcallosal areas. We stress in this paper that the subcallosal artery is the most important perforating artery of ACoA and the incidence of variations of ACoA is higher than previously reported.
在手术显微镜放大条件下，对25具尸体脑进行研究，观察前交通动脉（ACoA）及其穿支动脉的显微外科解剖结构，这些结构对于经终板间入路至关重要。所有病例均发现有ACoA，但其中60%存在变异，如丛状ACoA、凹陷型ACoA、窗孔型ACoA、三干A2和单干ACA。对于存在丛状ACoA、三干A2和单干ACA等变异的病例，切断和分离ACoA以获得更好的手术视野似乎较为困难。所有病例均观察到ACoA的穿支动脉。根据管径、起源、走行和终末部位，将其分为胼胝体下动脉、下丘脑动脉和视交叉动脉。在这三支动脉中，胼胝体下动脉被认为是导致记忆障碍、性格改变和心理异常的责任动脉，因为它终止于双侧胼胝体下区域。本文强调胼胝体下动脉是ACoA最重要的穿支动脉，且ACoA变异的发生率高于先前报道。
