目的:打开半球间显微外科手术走廊的屋顶以进入各种神经肿瘤学或神经血管病变可能是苛刻的,因为多个桥接静脉以高度可变的方式流入鼻窦,特定位置的解剖学。这项研究的目的是为这些矢状旁桥静脉提出一种新的分类系统,它们在本文中被描述为布置在具有4个排水路线的3个配置中。
方法:检查了20个成人尸体头部(40个半球)。从这次考试来看,作者描述了相对于特定解剖标志的矢状旁桥静脉的3种类型的配置(冠状缝合,中央后沟)及其引流途径进入上矢状窦,凸性硬膜,lacunae,还有Falx.他们还量化了这些解剖变异的相对发生率和范围,并提供了几种术前,术后,和微神经外科临床病例研究实例。
结果:作者描述了静脉引流的3种解剖结构,它改进了前面描述的两种类型。在类型1中,单个静脉连接;在类型2中,2个或更多个连续静脉连接;在类型3中,静脉复合体在同一点处连接。在冠状缝合线的前面,最常见的配置是1型硬脑膜引流,发生在57%的半球。在冠状缝和中央后沟之间,大多数静脉(包括Trolard的上吻合静脉的73%)首先排入静脉腔,在这个地区更大更多。中央后沟的后部,最常见的排水路线是通过falx。
结论:作者提出了矢状旁脉网的系统分类。使用解剖学标志,他们定义了3种静脉配置和4种引流途径。对手术路线的这些配置的分析表明,有2个高风险的半球间手术裂缝路线。这些风险可归因于存在接受多个静脉(2型)或静脉复合体(3型)配置的大的腔隙,这些腔隙对外科医生的工作空间和运动程度产生负面影响,因此容易发生无意的撕脱。出血,和静脉血栓形成。
OBJECTIVE: Opening the roof of the interhemispheric microsurgical corridor to access various neurooncological or neurovascular lesions can be demanding because of the multiple bridging veins that drain into the sinus with their highly variable, location-specific anatomy. The objective of this study was to propose a new classification system for these parasagittal bridging veins, which are herein described as being arranged in 3 configurations with 4 drainage routes.
METHODS: Twenty adult cadaveric heads (40 hemispheres) were examined. From this examination, the authors describe 3 types of configurations of the parasagittal bridging veins relative to specific anatomical landmarks (coronal suture, postcentral sulcus) and their drainage routes into the superior sagittal sinus, convexity dura, lacunae, and falx. They also quantify the relative incidence and extension of these anatomical variations and provide several preoperative, postoperative, and microneurosurgical clinical case study examples.
RESULTS: The authors describe 3 anatomical configurations for venous drainage, which improves on the 2 types that have been previously described. In type 1, a single vein joins; in type 2, 2 or more contiguous veins join; and in type 3, a venous complex joins at the same point. Anterior to the coronal suture, the most common configuration was type 1 dural drainage, occurring in 57% of hemispheres. Between the coronal suture and the postcentral sulcus, most veins (including 73% of superior anastomotic veins of Trolard) drain first into a venous lacuna, which are larger and more numerous in this region. Posterior to the postcentral sulcus, the most common drainage route was through the falx.
CONCLUSIONS: The authors propose a systematic classification for the parasagittal venous network. Using anatomical landmarks, they define 3 venous configurations and 4 drainage routes. Analysis of these configurations with respect to surgical routes indicates 2 highly risky interhemispheric surgical fissure routes. The risks are attributable to the presence of large lacunae that receive multiple veins (type 2) or venous complex (type 3) configurations that negatively impact a surgeon\'s working space and degree of movement and thus are predisposed to inadvertent avulsions, bleeding, and venous thrombosis.