Objective To study the neural, arterial and venous relationship in the middle incisural space in the region of the tentorial incisura and to determine the important clinical anatomical landmarks of these important neu...Objective To study the neural, arterial and venous relationship in the middle incisural space in the region of the tentorial incisura and to determine the important clinical anatomical landmarks of these important neurovascular structures. Methods Twenty adult cadaveric heads were examined using ×6 to ×40 magnification after perfusing the arteries and veins with colored latex and the relationship of the neural structures, arteries, veins were observed. The distances between the important neursovascular structures and landmarks were measured. Results The important cranial nerves related to the middle incisural space of the tentorial incisura are the oculomotor, the trochlear and the trigeminal nerves. And the important arteries related to the middle incisural space are posterior cerebral arteries and superior cerebellar arteries. The entrance site of oculomotor nerve to the roof of the cavernous sinus located at (11.2±4.3) mm posterior to the anterior clinoid process, (4.4±1.4) mm lateroposterior posterior to the posterior clinoid process. The entrance site of trochlear nerver located at (23.3 ± 3.0) mm posterior to anterior clinoid process, (14.5±3.9) mm lateroposterior posterior to the posterior clinoid process. The entrance site of oculomotor nerve located at (6.3±1.6) mm posterior to the supraclinoid portion of internal carotid artery, while that of the trochlear nerve at ((17.9±3.5)) mm to the supraclinoid portion of internal carotid artery. The entrance site of trochlear nerve located at (11.5±3.0) mm posterior to the entrance site of oculomotor nerve. Conclusions Anterior, posterior clinoid process and the supraclinoid portion of internal carotid artery are the important landmarks for the entrance site of the oculomotor and trochlear nerve. The superior cerebellar artery, the posterior cerebral artery and its important branches including the medial posterior choroidal artery and the long circumflex branch are all closely related to the middle incisural space, and should not be injured during operation.展开更多
文摘Objective To study the neural, arterial and venous relationship in the middle incisural space in the region of the tentorial incisura and to determine the important clinical anatomical landmarks of these important neurovascular structures. Methods Twenty adult cadaveric heads were examined using ×6 to ×40 magnification after perfusing the arteries and veins with colored latex and the relationship of the neural structures, arteries, veins were observed. The distances between the important neursovascular structures and landmarks were measured. Results The important cranial nerves related to the middle incisural space of the tentorial incisura are the oculomotor, the trochlear and the trigeminal nerves. And the important arteries related to the middle incisural space are posterior cerebral arteries and superior cerebellar arteries. The entrance site of oculomotor nerve to the roof of the cavernous sinus located at (11.2±4.3) mm posterior to the anterior clinoid process, (4.4±1.4) mm lateroposterior posterior to the posterior clinoid process. The entrance site of trochlear nerver located at (23.3 ± 3.0) mm posterior to anterior clinoid process, (14.5±3.9) mm lateroposterior posterior to the posterior clinoid process. The entrance site of oculomotor nerve located at (6.3±1.6) mm posterior to the supraclinoid portion of internal carotid artery, while that of the trochlear nerve at ((17.9±3.5)) mm to the supraclinoid portion of internal carotid artery. The entrance site of trochlear nerve located at (11.5±3.0) mm posterior to the entrance site of oculomotor nerve. Conclusions Anterior, posterior clinoid process and the supraclinoid portion of internal carotid artery are the important landmarks for the entrance site of the oculomotor and trochlear nerve. The superior cerebellar artery, the posterior cerebral artery and its important branches including the medial posterior choroidal artery and the long circumflex branch are all closely related to the middle incisural space, and should not be injured during operation.