Microstructure Anatomy Of Insula And Middle Cerebral Artery And Clinical Application

Objective: Through dissection of wet adult skull specimens andcollection and analysis the related data, explore and discuss the insula arterymicrostructure features and the relationship among insula, lateral fissure, basalganglia, and lateral ventricle. The study on the surgical treatment of lesions inthe region to provide accurate anatomic data, and increase the feasibility andsecurity of the operation, reduce surgical injury and postoperativecomplications provide effective theoretical guidance.Materials and Methods:5(10sides) Chinese adult wet skull specimenswhich are fixed in10%formaldehyde solution and the gender are difference.5(10sides) Chinese adult wet skull specimens which are fixed in10%formaldehyde solution are preserved skin and then color silicone vascularperfusion dyeing. Each case specimens were fixed in the headstock.Successively along the superciliary arches, zygomatic arch and the outer lineitem on the edge, on edge to do incision, step by step dissection and removecalvarium bone, except for the part of the sphenoid ridge, cut off the unilateraldura mater, fully show the bilateral cerebral hemisphere. Separation ofarachnoid membrane that covers the brain hemispheres, which are widelyopened the lateral fissure, insula. Look at the side of the outer as well as thecorresponding relationship between insula of the distribution of the arteries inthe brain cortex. The hard tissue by10%formaldehyde solution fixed and itselasticity is bad, it is difficult to through the pull of frontal orbit, lid of frontaland temporal cover cover the insula fully exposed, therefore island coverneeds to be removed. Fractional resection frontal orbit cover, lid of frontal andtemporal cover showed middle cerebral artery island paragraph, cover section,insula cortex, basal ganglia, and each part of the lateral ventricle, observingthe anatomical parts of a relationship, measure and collect related data. Statistical analysis: the experimental results data applications SPSS16.0statistical software for statistical analysis, the results calculated using mean±standard deviation (Mean±SD).Results: The average length of the superior periinsular sulcus is（58±1.35）mm. The average length of the inferior periinsular sulcus is（49±3.01）mm. The average length of the anterior periinsular sulcus is（28±1.79）mm. In this group8of10adult cadaver head specimens sidehemisphere island prefrontal groove and the continuity of the central sulcus ofthe ipsilateral cerebral cortex is good, the rest of the2side ofdiscontinuous.There are3short insular gyris in8side. There are4short insulargyris in1side. There are5short insular gyris in1side.We can find transversegyri in all insular.But the accessory gyri has not been found.There are2longinsular gyris in9sides. There are1long insular gyris in1side.The top part ofinsulais most close to the surface of the cerebral cortex.The average verticaldistance betweenthe top part of insula and lateral fissure surface is（12±0.68）mm. Threshold for the insular is located in lateral fissure of sphenoid bone andinsular cover attaches slightly uplift of the bow edge, before long island andorbitofrontal cortex between after back to back, by temporal extreme frontalorbit plane, its width is about (17±0.62) mm. Insula area of vascular anatomy:the threshold of MCA is located in the island from the brain underside to thelateral aspect of the insula and sheering, here the turning forming bent knees.This group of adult cadaver head specimens measured in knee Angle is91°~139°, average data is95°. MCA side of the main branch is located in theknee before1,8lateral knee, knee after1side. MCA main branch in line withthe three forms: double bifurcation to dry and dry, three bifurcation for the dry,dry and dry, split ends (4or more). This group of specimens is M2with doublebifurcation starting more than that under dry start in seven, with threebranches starting the3dry start2side, four bifurcation starting1side. M2each dry, delay the insula circuitry and fan distribution and bifurcate, step bystep to the turn-back line in the circle groove cover for M3segment on theisland. Middle cerebral artery M2way on each side of leaf in this group of specimens islands cortex bifurcate, on average,6.5. Insula artery by M2,single or supplied by dry starting and score the island cortex, each side of the65~117, an average of85. M2terminal branch of separate began in M2ofcortex or the power to the island of cortex or cover of arteries, and surelyincluding six hemisphere is visible.4hemisphere visible diameter0.4mm ormore perforators artery, enter point after the island area, M2terminal branchin angular gyrus arteries starting up, less starts at the top before and after topand dry, the artery. This group of specimens in the lateral bean grain arteriesstarting position exists larger variation,8visible near the bifurcation of thelateral hemisphere bean grain arteries, located on the2side, did not see thisgroup of specimens in dry under the lateral bean grain arteries.1side of thefrontal branch,1side both temporal branch of the lateral bean grain arteries.The lateral bean grain arteries after began in the inside wall turn and walk, rearHangYao turned on after4~6mm, eventually into the outer wear qualitydepartment before. This group of specimens at the lateral bean grain arteriesstarting point in the distance to the tip of the island20mm or less. Skin of theinsula and JiDeJieOu: reach the surface of the shell of nuclear island cortexdistance that is outside the capsule, screen outside the nucleus, the thickness is4.7mm. Insula and lateral ventricle: first island points to the lateral ventricleof the frontal average distance of11.15mm (9~13mm), prefrontal ditch andcircle groove intersection point on the island prefrontal groove on the end tothe body of lateral ventricle vertical distance of20.12mm (16~23mm), afterthe insula to point to the triangle of the vertical distance of lateral ventricle(8~13mm) is10.19mm, the circle groove Angle of the front end to thetemporal distance of9.12mm (7~11mm), the temporal Angle of vertexdistance, the threshold of10.18mm (9~14mm).Conclusion: Some scholars believe that the difficult surgery for curinginsula region of lesions, and the first choice is non-surgical treatment. It is dueto the importance and the function of insula area is uncertainty and thevascular wall which cover the surface of insula composed of middle cerebralartery and its branches. But most scholars believe that aggressive surgery based on clear understanding of the anatomy in the insula region is veryimportant. In this way we can do it and at the same time we can also reducethe postoperative losing of nerve function and cure the diseased maximum.When we have an operation in insula area, we can reach the operationfield through lateral fissure approach with method is the shortest distance andless damage. According to the position and In order to control and reducebleeding in operation better, the tumor can be reached by operating in the areawhich is lack of vascular. There are two areas which are lack of vascular, oneis the area between lenticulostriate arteries and the limen of insula whosewidth is about11mm.And the other is the area of the forward short gyri ofinsula. In order to choose more reasonable method of operating in insula andbasal ganglia, We need to evaluate the size of the tumor and the growthdirection，displacement and deformation of surrounding normal structures andthe distribution of the middle cerebral artery and its branches. This paperexpounds the relationship between insula and basal ganglia，The anatomy ofspecimens in this experiment provide guidance to identify the position of theimportant anatomical structure.