“椎动脉-硬膜动脉导管韧带”的解剖学及临床意义

doi:10.13418/j.issn.1001-165x.2020.06.003

中国临床解剖学杂志 ›› 2020, Vol. 38 ›› Issue (6): 635-638.doi: 10.13418/j.issn.1001-165x.2020.06.003

“椎动脉-硬膜动脉导管韧带”的解剖学及临床意义

孔祥玉¹，　杜心如²，　刘宏伟³，　王佳佳⁴

1.新乡医学院三全学院解剖学教研室，河南新乡 453003； 2.首都医科大学附属北京朝阳医院，北京 100020；
3.承德护理职业学院解剖学教研室，河北承德 067000； 4.大厂回族自治县人民医院超声影像科，河北大厂 065300

收稿日期:2019-12-03 出版日期:2020-11-25 发布日期:2020-12-08
通讯作者: 杜心如，教授，主任医师，E-mail：duxinru@163.com
作者简介:孔祥玉（1955-），男，河北围场县人，教授，研究生导师，主要从事应用解剖学及神经损伤与修复方面的研究，E-mail:kongxiangyu58@163.com

Anatomical observation on vertebral artery-dura mater arterial ductal ligament and its clinical significance

KONG Xiang-yu¹, DU Xin-ru², LIU Hong-wei³, WANG Jia-jia⁴

1. Department of Human Anatomy, Sanquan College of Xinxiang Medical College, Xinxiang 453000, China; 2. Beijing Chao-yang Hospital， Capital Medical University, Beijing 100020, China; 3. Department of Human Anatomy, Chengde Nursing Vocational College, Chengde 067000, China; 4. Department of Ultrasound Imaging, People's Hospital of Dachang Hui Autonomous County, Dachang 065300, Hebei Province, China

Received:2019-12-03 Online:2020-11-25 Published:2020-12-08

摘要/Abstract

摘要： 目的　探讨椎动脉第3段（V3段）的垂直段（V3v段）与硬膜囊前壁和周围骨性结构间的连接及其临床意义。方法　头颈标本16具（32侧），在C3~4节段，将V3段周围的软组织及其相关联的连接结构分离，探寻“椎动脉-硬膜动脉导管韧带”，观察其解剖学特点。取该韧带与椎动脉壁相连部，石蜡切片、HE染色，光镜观察、摄片。结果　所有标本在寰枕关节后内侧V3v段发现“椎动脉-硬膜动脉导管韧带”共11条（43.7%），长度9.25~4.76 mm，平均（7.39±1.33）mm，直径为（1.16±0.15）mm。该韧带出现于硬膜外层，自V3v段发出，末端分叉或呈分枝状穿入枕骨或连于硬膜。组织学特点为空心管状，管腔与椎动脉相通。结论　“椎动脉-硬膜导管韧带”是椎动脉连于硬膜和骨之间的空心圆索状结构，可能是椎动脉的脑膜后动脉闭锁形成，是有孔型椎动脉畸形的形态学基础，其对椎动脉的固定及头活动时颅内压的形成有一定作用。枕颈部显露椎动脉时此结构断裂可能是造成椎动脉大出血的原因。

关键词: 椎动脉, 　椎动脉-硬膜动脉导管韧带, 　硬脑膜, 　出血

Abstract: Objective　 To explore the fibrous connection structures between third section (V3 segment) of vertebral artery and dura mater sac as well as the surrounding bony structures of the occipital bone and also to explore the functional significance and discuss the clinical significance in hemorrhage caused by the vertebral artery rupture in operation.　Methods　Sixteen head linking neck specimens (32 sides) were selected for this investigation. The soft tissues surrounding the V3 segment of vertebral artery and the correlative connecting structure were separated. The vertebral artery-dura mater arterial ductal ligament were found and identified, their morphology and anatomical characteristics were observed. Choosing the typical vertebral artery-dura mater arterial ductal ligament to be cut into slices and stained by HE, and observed and photographed microscopically.　Results　Eleven (accounting for 43.7%) pieces of vertebral artery-dura mater arterial ductal ligament were founded among 32 sides of 16 head linking neck specimens. The longest length was 9.25 mm，the shortest was only 4.76mm. The average caliber and length were (1.16±0.15) mm and (7.39±1.33) mm respectively. The vertebral artery-dura mater arterial ductal ligament located deep to the dura meter, originated from the V3v sections and inserted either into the dura mater or into the bony structure by bifurcated several branches. The observation under light microscope showed that the histological characteristics were centrally hollow or tubular figuration, their lumen was connected with vertebral artery.　Conclusions　Vertebral artery-dura mater arterial ductal ligament is an arterial ligament connected between the V3 segment of vertebral artery and dura mater or basal part of the occipital bone. It is presented as a round tubular ligamental structure formed by occluded arterial branch arising from V3 segment of vertebral artery, it may have stationary function for V3v sections and have close relations with negative pressure formation in the cranial cavity.

Key words: Vertebral artery, 　Vertebral artery -dura mater arterial ductal ligament, 　Dura mater, Hemorrhage

中图分类号:

R323.1

孔祥玉, 杜心如, 刘宏伟, 王佳佳. “椎动脉-硬膜动脉导管韧带”的解剖学及临床意义[J]. 中国临床解剖学杂志, 2020, 38(6): 635-638.

KONG Xiang-yu, DU Xin-ru, LIU Hong-wei , WANG Jia-jia. Anatomical observation on vertebral artery-dura mater arterial ductal ligament and its clinical significance[J]. Chinese Journal of Clinical Anatomy, 2020, 38(6): 635-638.

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“椎动脉-硬膜动脉导管韧带”的解剖学及临床意义

Anatomical observation on vertebral artery-dura mater arterial ductal ligament and its clinical significance

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