The Vertebrobasilar Trunk and Its Anatomical Variants: A Microsurgical Anatomical Study
Gervith Reyes-Soto,
Julio C. Pérez-Cruz,
Luis Delgado-Reyes,
Carlos Castillo-Rangel,
Bernardo Cacho Diaz,
Gennady Chmutin,
Renat Nurmukhametov,
Galina Sufianova,
Albert Sufianov,
Vladimir Nikolenko,
Rinat Sufianov,
Evgeniy Goncharov,
Nicola Montemurro,
Manuel De Jesus Encarnacion Ramirez
Affiliations
Gervith Reyes-Soto
Unidad de Neurociencias, Department of Head and Neck, Instituto Nacional de Cancerología, Mexico City 04260, Mexico
Julio C. Pérez-Cruz
Laboratorio de Técnicas Anatómicas y Material Didactico, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 01070, Mexico
Luis Delgado-Reyes
Departamento de Anatomía, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
Carlos Castillo-Rangel
Department of Neurosurgery, Servicio of the 1ro de Octubre Hospital of the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City 07760, Mexico
Bernardo Cacho Diaz
Functional Neurosciences Unit, Mexico National Cancer Institute, Mexico City 07760, Mexico
Gennady Chmutin
Department of Neurological Surgery, Peoples Friendship University of Russia, 103274 Moscow, Russia
Renat Nurmukhametov
Department of Neurological Surgery, Peoples Friendship University of Russia, 103274 Moscow, Russia
Galina Sufianova
Department of Pharmacology, Tyumen State Medical University, 625000 Tyumen, Russia
Albert Sufianov
Department of Pediatric Neurosurgery of Federal Center of Neurosurgery, Federal Center of Neurosurgery of Ministry of Health of the Russian Federation, 625000 Tyumen, Russia
Vladimir Nikolenko
Department of Neurosurgery, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
Rinat Sufianov
Department of Human Anatomy, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
Evgeniy Goncharov
Department of Petrovsky Russian Scientific Center of Surgery, 121359 Moscow, Russia
Nicola Montemurro
Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), 56100 Pisa, Italy
Manuel De Jesus Encarnacion Ramirez
Department of Neurological Surgery, Peoples Friendship University of Russia, 103274 Moscow, Russia
Background: The trunk of the basilar artery has not been included in microanatomy studies. Anatomical variants of the perforant branches of the vertebrobasilar trunk and their relationship with neural structures are very important in surgical approaches. Surgical dissection for the treatment of vascular lesions requires a perfect knowledge of the microsurgical anatomy. Methods: We conducted a descriptive analysis of 50 brains, which were fixed with formalin at 10% for 2 weeks, and the arterial system was injected with colored latex. After microsurgical dissection, it was divided into three segments: the lower portion went from the anterior spinal artery to the anteroinferior cerebellar artery, the middle segment was raised from the upper limit of the lower portion to the origin of the superior cerebellar artery, and the upper segment ranged from the previous portion until the origin of the posterior cerebral artery. Results: The basilar artery had an average length of 30 mm. The average diameter at its junction with the vertebral arteries was 4.05 mm. The average middle segment was 3.4 mm in diameter and 15.2 mm in length. The diameter of the upper segment was 4.2 mm, and its average length was 3.6 mm. The average number of bulbar arteries was three, and their average diameter was 0. 66 mm. The number of caudal perforator arteries were five on average, with a diameter of 0.32 mm. We found three rare cases of anatomical variants in the vertebra–basilar junction. Conclusions: The basilar artery emits penetrating branches in its lower, middle, and upper portions. The origin of penetrating branches was single or divided after forming a trunk. However, we observed long branches from perforant arteries.
