【摘要】 目的研究展神经颅内段的显微解剖结构。方法对30个灌注红、蓝乳胶或硅橡胶的头颅标本进行解剖,观测颅内段展神经的位置、走行及重要毗邻关系。对岩斜段展神经进行苏木精-伊红染色,研究该段展神经硬膜鞘的构成。结果颅内段展神经分为脑池段、岩斜段和海绵窦段;共形成4个转角,分别为:穿硬脑膜处、岩尖、颈内动脉后曲或后升部外侧、海绵窦下动脉跨展神经处。脑池段展神经根腹面有小脑前下动脉、小脑后下动脉、脑桥下外侧动脉跨过,展神经根背面有小脑前下动脉、脑桥下外侧动脉跨过。岩斜段展神经与展神经硬膜鞘、Gruber韧带、Dorello管及脑膜背侧动脉关系密切。海绵窦下动脉在海绵窦段中部跨海绵窦段展神经,位置固定,交感神经出现在该动脉8mm范围内。结论脑池段展神经受血管压迫可导致展神经麻痹。岩斜段展神经与周围解剖结构毗邻关系复杂,熟知相关解剖关系,有助于岩斜段展神经受损的治疗。海绵窦下动脉是寻找海绵窦段展神经与交感神经的一个重要标志。更多还原

【Abstract】 Objective To study the microsurgical anatomical structure of abducens nerve in intracranial course. Methods Thirty cadaveric human heads injected with red or blue colored latex or silicon were dissected to observe the location, course and adjacent structures of the abducens nerve. Hematoxylin and Eosin (HE) staining of the abducens nerve in the petroclival segment was taken to observe the construction of dural sheath of the nerve. Results The abducens nerve had three segments: cisternal, petroclival and cavernous, and exhibited four different angulations, which were located at the dural porus, the petrous apex, the posterior bend or vertical portion of the internal carotid artery (ICA), and the site where artery of the inferior cavernous sinus crosses over the abducens nerve. In cisternal segment, the ventral surface of the abducens nerve root was crossed by the anterior inferior cerebellar artery (AICA), posterior inferior cerebellar artery, inferolateral pontine artery (ILPA), while the dorsal surface of the abducens nerve root was crossed by the AICA and ILPA. In petroclival segment, the abducens nerve had a close relationship with dural sheath, Gruber’s ligament, Dorello’s canal and the dorsal meningeal artery. The inferior cavernous sinus artery crossed the abducens nerve in the middle of the cavernous sinus, and the sympathetic nerve was found within 8 mm nearby the inferior cavernous sinus artery. Conclusion Vascular compression of abducens nerve root in cisternal segment might cause abducens nerve paralysis. The abducens nerve in petroclival segment has a complex location relationship with the adjacent anatomic structures. Knowledge on these anatomic relationships may help treating the injury of the abducens nerve in petroclival segment. The inferior cavernous sinus artery is an important landmark to seek for the abducens nerve and sympathetic nerve.更多还原