Microanatomy of M1 bifurcation of middle cerebral artery and clinical significance
ZHAO Hong-xiang1, WANG Zhong2, WU Yu2, YU Nian-zhu3
(1.Department of Neurosurgery, TCM Hospital of Wujin, Changzhou Jiangsu 213152; 2.Department of Neurosurgery, the First Affiliated Hospital of Soochow University,Soochow Jiangsu 215006; 3.Department of Neurosurgery, Children′s Hospital of Jiangxi, Nanchang Jiangxi 330006, China)
Abstract：Objective: To research on the surface projection of the bifurcation of M1, and the relationship between the M1 bifurcation and the superficial sylvian veins；on purpose it could offer reference data and space quantification concepts for operations operated trough lateral fissure. Methods: On 30 samples of adult heads fixed with formaldehyde solution, we used red latex to pour into the bilateral internal carotids and vertebral arteries, and undertook pterion approach from the left and right separately. We set a coordinate axe on the samples,and measured the number of the projection of the M1 bifurcation on this coordinate.We observed the relationships between the M1 bifurcation and the superficial sylvian veins under different head positions, and measured the vertical distance between them.Results: The projection of the M1 bifurcation was:x-axis of the left (26.56±3.03)mm;y-axis of the left(46.71±4.24)mm;x-axis of the right(27.03±2.92)mm;y-axis of the right: (45.48±4.20)mm.In a circular range with a center located at x=25.0 mm and y=45.0 mm,and a radius of 10 mm,there were 27 samples of projections of M1 segment(90.00%).When the head was turned by 30° toward the opposite side, the M1 bifurcations all lay in the lateral of the superficial sylvian veins, and when turned by 60°, there were 4 samples that lay in the left and 5 samples in the right of the lateral of the superficial sylvian veins, and the rest all lay below the superficial sylvian veins.The vertical distance between the M1 bifurcation and the superficial sylvian vein was:left(14.60 2.27)mm;right(15.03 2.36)mm.Conclusions: The real bifurcation of the M1 segment always lies on the top of the limen of insula.The relationship between the M1 bifurcation and the superficial sylvian vein is closely related to the head position.
[1]McCarron MO,Nicoll JA.Cerebral amyloid angiopathy and thrombolysisrelated intracerebral haemorrhage[J].Lancet Neurol,2004,3(8):484-492.[2]Rinne J, Hernesniemi J, Niskanen M,et al. Analysis of 561 patients with 690 middle cerebral artery aneurysms:anatomic and clinical features as correlated to management outcome[J].Neurosurgery,1996,38(1):2-11.[3]Yasargil MG, Fox JL. The microsurgical approach to intracranial aneurysms[J].Surg Neurol,1975,3(1):7-14.[4]Tanriover N, Rhoton AL Jr,Kawashima M,et al. Microsurgical anatomy of the insula and the sylvian fissure[J].J Neurosurg,2004,100(5):891-922.
2013, Vol. 23 
