Microanatomic Study Of Basilar Artery Bifurcation Through Pterional Approach

Objective:(1) To study the microsurgical anatomy of the corresponding parts of the structure through Pterional Approach, and observe the basilar artery bifurcation revealed its relationship with the surrounding blood vessels and nerves;(2) To observe and measure itinerary of the basilar artery bifurcation, the main branches, variation, and with the surrounding blood vessels and nerves gradually after remove the scalvaria and part of brain tissue, provide an anatomical basis for the region of clinical surgery, interventional procedures etc.Methods:to get10adults cadaveric heads which are thoughly soaked in formaldehyde solution. Step dissect the cadaveric heads vio pterional approach observe the basilar artery bifurcation revealed its relationship with the surrounding blood vessels and nerves through saddle area space Ⅱand Ⅲ. Remove the scalvaria and part of brain tissue, and observe and measure itinerary of the basilar artery bifurcation, the main branches, variation, and relationship with the surrounding blood vessels (SCA.PCA.Central medial artery, etc) and nerves (Oculomotor nerve).Results:(1)The left lateral side length of Saddle area space Ⅱ is (6.69±2.45)mm, the left medial side length is (6.52±1.77)mm, the left bottom edge length is (3.35±1.88)mm. The right lateral side length is (6.72±2.03)mm, the right medial side length is (6.57±1.69)mm, the right bottom edge length is(3.47±1.57)mm. Bilateral contrast has no significant difference; The left lateral side length of Saddle area space Ⅲ is (7.13±1.73)mm, the left medial side length is (6.35±1.48)mm, the left bottom edge length is(4.95±1.78)mm. The right lateral side length is(7.54±1.52)mm, the right medial side length is (6.67±1.39)mm, the right bottom edge length is (5.11±1.54)mm. Bilateral contrast has no significant difference;(2)70%of the basilar artery bifurcation was observed through Saddle area space Ⅱ, revealed basilar artery trunk length is (5.56±1.54)mm, blood vessel diameter is (3.02±0.87)mm.80%of the basilar artery bifurcation was observed through Saddle area space Ⅲ, revealed basilar artery trunk length is (6.83±1.06)mm, blood vessel diameter is (3.14±1.14)mm.2sets of data by statistical comparison p<0.05were statistically significant;(3)The length of left posterior cerebral artery P1segment is (7.70±0.21) mm, blood vessel diameter is (2.29±0.04) mm. The right of left posterior cerebral artery P1segment is (7.56±0.18) mm, blood vessel diameter is (2.25±0.05) mm.2sets of data by statistical comparison have no significant difference; the number of central medial artery of P1segment are4.45, blood vessel diameter is (0.79±0.34) mm. The blood vessel diameter of the beginning part of the left SCA is (1.25±0.31) mm, The blood vessel diameter of the beginning part of the right SCA is (1.34±0.33) mm; The of the Pool paragraph oculomotor is (9.76±0.85) mm, the board of it is (2.53±0.37) mm, Intermediate thickness is (1.49±0.21) mm.Conclusions:Familiar with and master the saddle area of the clearance of space Ⅱ and space Ⅲ clearance for the completion of the pterional approach to basilar artery bifurcation of surgery have a greater clinical significance; Space Ⅲ have an advantage than space Ⅱ in the unveil of the basilar artery bifurcation; Basilar artery bifurcation and its surrounding structures anatomical relationship is complex, and large variation. We can grasp its microscopic anatomy through this study and have important clinical significance in clinical surgery or interventional procedures of this region.