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目的 :研究视神经和视交叉的形态结构特点及其临床意义。方法 :在手术显微镜下观测 15个尸体标本的视神经和视交叉的形态特征及毗邻关系。结果 :镰状皱襞沿视神经的长度为 0 .4～ 4.6mm ,1/3的视神经前段隆突 ,鞍结节均较平坦 ,多数视交叉后缘位于鞍背后方。视神经主要由垂体上前动脉供血 ,半数有分支沿视神经前行。视交叉的上面多由前交通动脉复合体供血 ,下面的内侧部多为垂体上动脉供血 ,外侧部多为颈内动脉和后交通动脉的分支供血。视神经上面覆有一层蛛网膜 ,再上面为直回下面的软脑膜 ,二膜间多数分开。结论 :国人鞍结节边界不易确定 ,按传统方法将视交叉分型有困难 ,所以宜按蝶棱与视交叉前缘间距判断前置或后置。手术中易损伤沿视神经行走的小动脉 ,电凝须特别小心。贴视神经上抬直回 ,实际上是沿粘着较少的界面分离 ,有半数需离断一些纤维小梁
Objective: To study the morphological characteristics of optic nerve and optic chiasm and their clinical significance. Methods: Morphological features and adjacent relations of optic nerve and optic chiasm were observed in 15 corpse specimens under a surgical microscope. Results: The length of optic nerve of sickle fold was 0.4-4.6 mm. One third of optic nerve anterior segment protuberance and saddle nodule were flat. The majority of optic chiasm posterior margin was located in the dorsal ramus. The optic nerve is mainly supplied by the pituitary anterior artery, and half of the optic nerve branches along the optic nerve. Most of the optic chiasm by the anterior communicating artery complex blood supply, the following medial pituitary artery mostly for the supply of blood, the lateral part of the internal carotid artery and posterior communicating artery for the majority of blood supply. The top of the optic nerve is covered with a layer of arachnoid, followed by direct back to the following pia mater, most of the two membranes separated. Conclusion: It is not easy to determine the saddle nodule boundary of Chinese people. It is difficult to classify the optic chiasm according to the traditional method. Surgery easy to damage the small arteries walking along the optic nerve, electric coagulation must be especially careful. Posterior optic nerve uplift straight back, in fact, along the adhesion less interface separation, there are some to be broken off some of the fiber trabecular