neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"neurosurgery-89Research ArticleОРИГИНАЛЬНАЯ РАБОТАORIGINAL REPORTИндивидуальная анатомическая изменчивость верхней мозжечковой артерииThe individual anatomical variability of superior cerebellar arteryЛюньковаРегина НиколаевнаLiun’KovaR. N.noemail@neicon.ruКрыловВладимир ВикторовичKrylovV. V.noemail@neicon.ruМосковский государственный медико-стоматологический университет им. А.И. Евдокимова; НИИ скорой помощи им. Н.В. СклифосовскогоRussian Federation201405102017021732Copyright © Люнькова Р.Н., Крылов В.В., 20172017Люнькова Р.Н., Крылов В.В.Liun’Kova R.N., Krylov V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/89

Цель исследования. Изучение индивидуальной анатомической изменчивости верхней мозжечковой артерии (ВМА) и её ветвей. Материалы и методы. Изучено 100 ВМА на 50 анатомических препаратах головного мозга. Изучали особенности расположения ВМА по отношению к стволу головного мозга, ножке мозга, поверхностям мозжечка. Анатомическое исследование проводили с применением поэтапной микропрепаровки, микрофотографирования, моделирования хирургических доступов и морфометрии. Результаты. Описано расположение истока и переднего понтомезенцефалического сегмента ВМА относительно спинки турецкого седла и свободного края намета мозжечка, коррелирующее с угловыми параметрами основания черепа. Установлено, что ВМА образует основные 3 типа ветвления. Описаны перфорирующие ветви, отходящие от основного, рострального и каудального стволов ВМА. Установлено, что петрозальная поверхность мозжечка питается маргинальными ветвями, исходящими от основного (II тип) или каудального стволов (I тип), либо маргинальная ветвь является нижним стволом в случае удвоенной ВМА. Описана топография сосуда относительно V нерва. Заключение. Положение проксимальных отделов ВМА коррелирует с краниальными параметрами. В половине случаев ВМА контактирует с V нервом. В 1/3 случаев проксимальная часть ВМА формирует перфорирующие сосуды межножковой ямки. Примерно в 1/4 случаев основным источником для перфорирующих артерий ствола была нижняя удвоенная ВМА. Описанные топографические особенности индивидуального строения ВМА важно учитывать при выборе доступа к верхушке базилярной артерии, вырезке намета мозжечка, V нерву, петрокливальной и пинеальной областям.

Objective. To examine the individual anatomical variability of superior cerebellar artery (SCA) and its branches. Material and methods. The total amounts of 100 SCA were studied using 50 anatomical specimen of brain. The features of SCA localization in relation to brain stem, cerebral peduncle and cerebellar surfaces were examined. This anatomical study was conducted using step-by-step microdissection, microphotography, modeling of surgical approaches and morphometry. Results. The localization of orifice and anterior pontomesencephalic segment of SCA in relation to clinoid plate and free edge of tentorium cerebelli correlated with angular parameters of skull base is described. It is found that branching of SCA can be divided into 3 main types. The perforating branches arising from main, caudal and rostral trunks of SCA are also described. It is confirmed that petrosal surface of cerebellum is supplied by marginal branches arising from the main (II type) or caudal (I type) trunks or marginal branch is the lower trunk of doubled SCA. The topography of SCA in relation to V nerve is described. Conclusion. The position of proximal parts of SCA is correlated with cranial parameters. SCA contacts with V nerve in half of cases as well as proximal part of SCA forms the perforating vessels of interpeduncular fossa in one-third cases. The lower doubled SCA was the main source of perforating arteries for brain stem approximately in one forth cases. It is important to take into account these described topographic features of individual variability of SCA while choosing the surgical approach to basilar artery apex, tentorial incisura, V nerve, petroclival and pineal areas.

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The authors declare that there are no conflicts of interest present.