【摘要】 ①目的探讨垂体瘤引起视功能障碍的机制。②方法采用显微解剖技术对10例福尔马林固定、红色乳胶动脉灌注后的成人脑标本的垂体前上动脉进行观察和测量。③结果垂体前上动脉起自颈内动脉床突上段(C2段)内侧壁,起始部直径平均(0.34±0.07)mm,向后内上方走行,在(7.49±1.2)mm处发出返支,供应视交叉前角与邻近视交叉部位视神经的内侧面和下面,终支在视交叉中部和垂体柄基部前方,与对侧的垂体前上动脉吻合,然后发出数条亚支,分布于视交叉下面中部软膜和垂体柄。垂体前上动脉与同侧垂体后上动脉在垂体柄上吻合,并与来自大脑前动脉或前交通动脉的穿动脉在视交叉软膜上吻合,但在其行程中,其主干不与其他穿支动脉吻合。④结论垂体前上动脉受到压迫导致视路缺血,可能是垂体瘤患者常出现视力下降、双颞侧视野缺损的最主要原因之一。更多还原

【Abstract】 Objective To illustrate the mechanism of visual disturbance caused by pituitary adenomas, microanatomical characters of anterior superior hypophyseal artery (ASHA) were studied.Methods ASHAs of 10 adult brain specimens, which were fixed with formalin and injected with colored mass, were observed and took measure using microanatomical technique.Results ASHA arises from the medial wall of supraclinoid segment (C2 segment) of internal carotid artery (ICA), runs medially, posteriorly and superiorly. The diameter of the original part averages 0.34±0.07 mm. It sends a recurrent branch at the point of 7.49±1.20 mm after leaving ICA. The recurrent branch feeds anterior chiasmal angle, medial and inferior aspects of the proximal optic nerve (ON). The terminal branch of ASHA, as a major trunk, intermingles with the conterlateral one before the base of pituitary stalk (PS) and below the optic chiasma (OC). Then, the anstomosis sends a number of twigs to inferior aspect of chiasmal middle part. In addition , ASHA joins with posterior superior hypophyseal artery (PSHA) on PS and with some perforating branches originating from anterior cerebral artery (ACA) or anterior communicating artery (ACoA) on pia mater of OC, but their major trunks don’t communicate each other during the course.Conclusion The patients with pituitary adenomas usually present visual loss and bilateral temporal visual field defects. It is possibly one of the major causes that ASHAs were compressed and followed by ischemia of visual passway .更多还原