Embryological basis of some aspects of cerebral vascular fistulas and malformations
Embryological basis of some aspects of cerebral vascular fistulas and malformations
复制标题
DOI：
10.3171/jns.1996.85.1.0001
复制
发表时间：
1996-07-01
影响因子：
4.1
通讯作者：
Macdonald, RL
中科院分区：
文献类型：
--
作者：
Mullan, S;Mojtahedi, S;Macdonald, RL
回顾有关脑静脉形成的文献，以便更好地了解一些脑血管异常。临床观察结果如眼上静脉通过眶下裂而不是眶上裂进入海绵窦、存在广泛海绵窦瘘时大脑中静脉回流相对较少、以及岩下瘘出血相对较少等都与旧静脉通路的持续存在有关。与岩上窦瘘相关的出血的频繁发生以及岩上窦与海绵窦连接的频繁失败同样具有胚胎学解释。盖伦动脉瘤静脉与直窦缺失或变形的频繁关联可能与成对的大脑内静脉融合成一个通道的时间有关。据推测，脑静脉畸形（CVM）和动静脉畸形（AVM）的起源可能与表面静脉的顺序形成和吸收有关，表面静脉在人类胚胎发育过程中主要发生在40至80毫米的长度区间，尽管即使出生后AVM也可能持续生长。大脑中静脉经常缺失或异常，并且在存在 CVM 和 AVM 的情况下无法与海绵窦连通，这与该静脉的晚期发育及其更晚与海绵窦的连接有关。
The literature on the formation of cerebral veins is reviewed to obtain a better understanding of some cerebrovascular anomalies. Clinical observations such as the entry of the superior ophthalmic vein into the cavernous sinus through the inferior rather than the superior orbital fissure, the relative infrequency of middle cerebral vein backflow in the presence of an extensive cavernous fistula, and the relative infrequency of hemorrhage in relation to the inferior petrosal fistula all relate to the persistence of an older venous pathway. The frequent occurrence of hemorrhage in association with the superior petrosal sinus fistula and the frequent failure of the superior petrosal sinus to connect to the cavernous sinus similarly have an embryological explanation. The frequent association of the vein of Galen aneurysm and an absent or deformed straight sinus probably relates to the time at which the paired internal cerebral veins fuse into one channel. It is speculated that the origins of cerebral venous malformations (CVMs) and arteriovenous malformations (AVMs) probably relate to sequential formation and absorption of surface veins, which occur in human embryonic development mainly in the 40- to 80-mm length interval, although persistent AVM growth is possible even after birth. The frequent absence or anomaly of the middle cerebral vein and its failure to communicate with the cavernous sinus in the presence of both CVMs and AVMs are linked to the late development of that vein and to its even later connection to the cavernous sinus.