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Middle cerebral artery revascularization: anatomical studies and considerations on the anastomosis site

Revascularização da artéria cerebral média: estudo anatômico e considerações sobre o local de sutura

Abstracts

In the surgical management of skull base lesions and vascular diseases such as giant aneurysms, involvement of the internal carotid artery may require the resection or the occlusion of the vessel. The anastomosis of the external carotid artery and the middle cerebral artery with venous graft may be indicated to re-establish the blood flow. To determine the best suture site in the middle cerebral artery, an anatomical study was carried out. Fourteen cerebral hemispheres were analysed after the injection of red latex into the internal carotid artery. The superior and inferior trunk of the main division of the middle cerebral artery have more than 2 mm of diameter. They are superficial allowing an anastomosis using a venous graft. The superior trunk has a disadvantage, it gives rise to branches for the precentral and post-central giri. The anastomosis with the inferior trunk presents lower risk of neurological deficit even though the angular artery originates from it.

middle cerebral artery; anastomosis; revascularization; anatomy


No tratamento cirúrgico das lesões da base do crânio e patologias vasculares como aneurismas gigantes, a ressecção ou oclusão da artéria carótida interna pode ser necessária. A anastomose das artérias carótida externa e cerebral média com interposição de enxerto venoso pode ser utilizada para restabelecer o fluxo sangüíneo. Para determinar o melhor local de sutura na artéria cerebral média, realizou-se um estudo anatômico. Quatorze hemisférios cerebrais foram analisados depois da injeção de látex vermelho na artéria carótida interna. Os ramos superior e inferior da divisão principal da artéria cerebral média têm mais de 2 mm de diâmetro. Eles são superficiais e permitem uma anastomose utilizando um enxerto venoso. O tronco superior tem a desvantagem de dar origem aos ramos para os giros pré e pós-centrais. A anastomose com o tronca inferior apresenta menor risco de déficit neurológico, apesar da artéria angular ter origem desse vaso.

Artéria cerebral média; anastomose; revascularização; anatomia


Middle cerebral artery revascularization: anatomical studies and considerations on the anastomosis site

Revascularização da artéria cerebral média: estudo anatômico e considerações sobre o local de sutura

Murilo S. MenesesI; Ricardo RaminaII; Andrea P. JackowskiIII; Ari A. PedrozoIV; Robertson B. PachecoV; Mário H. TsubouchiVI

IHospital das Nações, Curitiba: MD, PhD, Neurosurgeon, Professor of Anatomy of Federal University of Parana (UFPR)

IIHospital das Nações, Curitiba: MSc, MD, Neurosurgeon

IIIHospital das Nações, Curitiba: Biologist, taking the Master of Science Degree in Anatomy

IVHospital das Nações, Curitiba: MD, Neurosurgeon

VHospital das Nações, Curitiba: MD, Resident of Neurosurgery

VIHospital das Nações, Curitiba: MD, Neurologist

ABSTRACT

In the surgical management of skull base lesions and vascular diseases such as giant aneurysms, involvement of the internal carotid artery may require the resection or the occlusion of the vessel. The anastomosis of the external carotid artery and the middle cerebral artery with venous graft may be indicated to re-establish the blood flow. To determine the best suture site in the middle cerebral artery, an anatomical study was carried out. Fourteen cerebral hemispheres were analysed after the injection of red latex into the internal carotid artery. The superior and inferior trunk of the main division of the middle cerebral artery have more than 2 mm of diameter. They are superficial allowing an anastomosis using a venous graft. The superior trunk has a disadvantage, it gives rise to branches for the precentral and post-central giri. The anastomosis with the inferior trunk presents lower risk of neurological deficit even though the angular artery originates from it.

Key words: middle cerebral artery, anastomosis, revascularization, anatomy.

RESUMO

No tratamento cirúrgico das lesões da base do crânio e patologias vasculares como aneurismas gigantes, a ressecção ou oclusão da artéria carótida interna pode ser necessária. A anastomose das artérias carótida externa e cerebral média com interposição de enxerto venoso pode ser utilizada para restabelecer o fluxo sangüíneo. Para determinar o melhor local de sutura na artéria cerebral média, realizou-se um estudo anatômico. Quatorze hemisférios cerebrais foram analisados depois da injeção de látex vermelho na artéria carótida interna. Os ramos superior e inferior da divisão principal da artéria cerebral média têm mais de 2 mm de diâmetro. Eles são superficiais e permitem uma anastomose utilizando um enxerto venoso. O tronco superior tem a desvantagem de dar origem aos ramos para os giros pré e pós-centrais. A anastomose com o tronca inferior apresenta menor risco de déficit neurológico, apesar da artéria angular ter origem desse vaso.

Palavras-chaves: Artéria cerebral média, anastomose, revascularização, anatomia.

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

Aceite: 1-novembro-1996.

Dr. Murilo S. Meneses - Avenida Getúlio Vargas 2159 - 80250-180 Curitiba PR - Brasil.

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Publication Dates

  • Publication in this collection
    10 Nov 2010
  • Date of issue
    1997
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