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.
Subject(s)
Humans , Cerebral Arteries/anatomy & histology , Cerebral Arteries/surgery , Cerebral Revascularization , Anastomosis, Surgical , Carotid Arteries/surgeryABSTRACT
O tratamento cirúrgico das lesoes localizadas no clivus, junçao craniocervical e coluna cervical alta pode se acompanhar de morbidade e mortalidade importantes. O acesso transoral é uma via direta e adequada para essa regiao. Para estudar as relaçoes anatômicas desse acesso, realizou-se um estudo em 15 hemicabeças de cadáveres fixados em formalina a 20 por cento. As principais distâncias envolvendo o acesso transoral foram medidas para determinar seus limites e suas vantagens.