摘要
目的通过了解颅内存在病变时上矢状窦旁桥静脉侧支循环的建立模式，为预防经纵裂入路术后发生静脉性脑梗死提供影像学依据。方法回顾性分析影响上矢状窦血流的30例脑膜瘤患者手术前后影像学及临床资料。结果上矢状窦后1／3或窦汇处闭塞时，主要通过与外侧裂浅静脉、导静脉、半球外侧异常硬脑膜静脉窦等建立侧支循环；上矢状窦中1／3闭塞时，主要通过闭塞前段与外侧裂浅静脉、闭塞后段与Labb6静脉及导静脉等建立侧支循环；病变影响到上矢状窦血流，但仍通畅时，主要通过瘤周静脉网及纵裂内侧面引流静脉建立上下矢状窦间侧支循环。30例脑膜瘤术中离断桥静脉5例，其中2例发生严重脑水肿。结论不同部位病变引起上矢状窦血流变化时所建立侧支循环的模式是不同的，术前明确侧支循环的建立模式，对计划经纵裂入路以及处理侵及上矢状窦的肿瘤是十分必要的。
Objective To provide image basis for prevention postoperative venous infarction via interhemispheric approaches by understanding the patterns of collateral circulation of bridging veins. Methods To analyze retrospectively pre - and post - operative outcomes of imaging and clinical data of 30 cases meningiomas that influenced the bloodflow of superior sagittal sinuses （SSS）. Results When posterior third of SSS or toreular herophili were obstructed, the patterns of venous drainage were through end - to - end anastomoses of the superficial sylvian veins, emissary veins and abnormal dural venous sinuses. When middle third of SSS were obstructed, the patterns of venous drainage were through end - to - end anastomoses of the superficial sylvian veins in presegment of occlusion and the anastomoses of Labbe vein in postsegment of occlusion and emissary veins. When the blood flow of SSS was influenced by lesions and SSS wasnt be obstructed, the patterns of venous drainage were through peritumoral vein nets and draining veins of medial interhemispheric veins. Among 30 cases meningiomas, ：2 of 5 cases whose bridging veins were obstructed had severe postoperative cerebral edema and inflated. Conclusion There were different patterns of collateral circulation of bridging veins when different lesions caused the change of bloodflow of SSS. It was very necessary for planning interhemispheric approaches and treating the tumors that involved in SSS to understand the patterns of collateral circulation in preoperation.
出处
《中华神经外科杂志》
CSCD
北大核心
2010年第4期326-329,共4页
Chinese Journal of Neurosurgery
关键词
侧支循环
桥静脉
上矢状窦
外科策略
Collateral circulation
Bridging veins
Superior sagittal sinuses （SSS）
Surgical strategey
