Anatomical Study Of The Perforating Artery Of A1 Segment Of Anterior Cerebral Artery And Its Application In The Resection Of The Craniopharyngioma

objective By dissecting A1 segment of anterior cerebral artery and its perforating artery in cadaveric specimens(cadaveric head),the distribution of these important arteries was summarized in order to provide help for clinical operation in Sellar region.Combined with the clinical resection of craniopharyngioma,the significance of the medial part of the superior space of internal carotid artery composed of A1 segment of anterior cerebral artery and its perforating artery in the resection of craniopharyngioma was discussed.Methods The distribution characteristics,diameter and length of A1 segment of anterior cerebral artery and perforating artery were observed,measured and recorded in 10 cases(20 sides)of adult cadaveric head specimens.each A1 segment was divided into three equal parts according to its length,From the outside to the inside,include the outer 1/3,the middle 1/3 and the inner 1/3,The number of branches of the perforating artery in each part was calculated,and statistical analysis was performed.At the same time,the perforating artery was explored in 13 patients with clinical patients undergoing the frontal-endplate approach and the tumor was removed by the medial part of the V-stomach.To elucidate the distribution of A1 segment and perforating artery of anterior cerebral artery and the feasibility and advantages of medial part of superior carotid artery in resection of craniopharyngioma.Results The anatomical specimen did not find the absence of the A1 segment of the anterior cerebral artery.The perforating artery of the A1 segment was mainly emitted from the upper arm and the posterior wall of the A1 segment(one variation was found in the anatomy as shown in Figure I.B).Among them,inside 1/3 of A1 is issued(2.65±0.67),middle 1/3 is issued(1.2±0.83),and the outer 1/3 is issued(3.8±1.77).There were significant differences in the number of perforating arteries between inside 1/3,middle 1/3 and outer 1/3(P<0.05).There was no significant difference in A1 diameter,A1 length and the total number of perforating arteries between the outer 1/3 segment and the middle 1/3 segment,between the outer 1/3 segment and the inner 1/3 segment(P>0.05).The perforating artery terminates in the anterior penetrating substance,optic chiasma and dorsal side of optic tract,anterior part of hypothalamus,lateral fissure and inferior surface of frontal lobe.The average number of perforating arteries was 8.13 patients with craniopharyngioma were treated by clinical operation,including total resection in 12 cases and subtotal resection in 1 case.The patients were followed up for 5 months to 2.5 years without recurrence.Conclusion The anterior cerebral artery A1 segmental perforating artery is mainly distributed in inside 1/3 and outer 1/3 of the A1 segment.In the process of resection of the saddle area tumor through the frontal-endplate approach,the operation of the medial part of the fifth interspace is performed on the basis of the operation of the I,II,and IV interspace.Because middle 1/3 of the A1 segment has fewer perforating arteries,the operation is safe and effective and the patient recovers better.