Summary
The microsurgical anatomy of the arteries of the pituitary stalk and gland as viewed from above was studied in 50 adult cadaveric hemispheres using the operating microscope. There were three types of vessels to the pituitary from above: the superior hypophyseal artery originating from the internal carotid artery, the infundibular artery from the posterior communicating artery, and the prechiasmal artery from the ophthalmic artery. The superior hypophyseal artery originated from the medial to posterior aspect of the internal carotid artery. The average number of vessels of the superior hypophyseal artery was 2.2 per hemisphere, and the diameter was 0.25 mm on average. The majority (76%) of superior hypophyseal arteries arose from the proximal half of the segment between the origins of the ophthalmic and posterior communicating arteries of the internal carotid artery. The infundibular artery originated mainly from the medial side (69%) of the posterior communicating artery. Its diameter was 0.22 mm, and number 0.23 per hemisphere. The number of prechiasmal arteries was 0.06 per hemisphere. As a result, there were on average 2.5 vessels per hemisphere, totally 5 per brain, with the average diameter 0.25 mm, supplying the pituitary stalk and gland from above. The clinical application of these anatomical data to the diagnosis and treatment of suprasellar tumours and carotidophthalmic aneurysms is discussed.
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References
Almeida GM, Shibata MK, Biano E (1976) Carotid-ophthalmic aneurysms. Surg Neurol 5: 41–45
Baker HL Jr (1972) The angiographic delineation of sellar and parasellar masses. Radiology 104: 67–78
Benedetti A, Curri D (1977) Direct attack on carotid ophthalmic and large internal carotid aneurysms. Surg Neurol 8: 49–54
Bergland R, Ray BS (1969) The arterial supply of the human optic chiasm. J Neurosurg 31: 327–334
Dawson BH (1958) The blood vessels of the human optic chiasma and their relation to those of the hypophysis and hypothalamus. Brain 81: 207–217
Ferguson GG, Drake CG (1981) Carotid-ophthalmic aneurysms: Visual abnormalities in 32 patients and the results of treatment. Surg Neurol 16: 1–8
Gibo H, Lenkey C, Rhoton AL Jr (1981) Microsurgical anatomy of the supraclinoid portion of the internal carotid artery. J Neurosurg 55: 560–574
Guidetti B, La Torre E (1975) Management of carotidophthalmic aneurysms. J Neurosurg 42: 438–442
Harris FS, Rhoton AL Jr (1976) Microsurgical anatomy of the cavernous sinus. A microsurgical study. J Neurosurg 45: 169–180
Hughes B (1958) Blood supply of the optic nerves and chiasma and its clinical significance. Br J Ophthalmol 42: 106–125
Kothandaram P, Dawson BH, Kruyt RC (1971) Carotidophthalmic aneurysms. A study of 19 cases. J Neurosurg 34: 544–548
Lang J (1983) Clinical anatomy of the head. Neurocranium, orbit, craniocervical regions. Springer, Berlin Heidelberg New York, pp 142–143
Lang J (1985) Hypophyseal region-anatomy of the operative approaches. Neurosurg Rev 8: 93–124
Lasjaunias P, Moret J, Mink J (1977) The anatomy of the inferolateral trunk (ILT) of the internal carotid artery. Neuroradiology 13: 215–220
Lasjaunias PL (1981) Craniofacial and upper cervical arteries. Functional, clinical and angiographic aspects. Williams and Wilkins, Baltimore, pp 32–60
McConnell EM (1953) The arterial blood supply of the human hypophysis cerebri. Anat Rec 115: 175–201
Morgan MK, Johnston IH, Silva M de (1985) Treatment of ophthalmofacial-hypothalamic arteriovenous malformation (Bonnet-Dechaume-Blanc syndrome). Case report. J Neurosurg 63:794–796
Nakao S, Kikuchi H, Takahashi N (1981) Successful clipping of carotid-ophthalmic aneurysms through a contralateral pterional approach. J Neurosurg 54: 532–536
Nishio S, Matsushima T, Fukui M, Sawada K, Kitamura K (1985) Microsurgical anatomy around the origin of the ophthalmic artery with reference to contralateral pterional surgical approach to the carotid-ophthalmic aneurysm. Acta Neurochir (Wien) 76: 82–89
Parkinson D (1964) Collateral circulation of cavernous carotid artery: Anatomy. Can J Surg 7: 251–268
Parkinson D (1965) A surgical approach to the cavernous portion of the carotid artery: Anatomical studies and case report. J Neurosurg 23: 474–483
Renn WH, Rhoton AL Jr (1975) Microsurgical anatomy of the sellar region. J Neurosurg 43: 288–298
Saeki N, Rhoton AL Jr (1977) Microsurgical anatomy of the upper basilar artery and the posterior circle of Willis. J Neurosurg 46: 563–578
Stanfield JP (1960) The blood supply of the human pituitary gland. J Anat 44: 257–273
Stephens RB, Stilwell DL (1969) Arteries and veins of the human brain. Ch C Thomas, Springfield, Ill, pp 10–13
Sugita K (1985) Microneurosurgical atlas. Springer, Berlin Heidelberg New York Tokyo, pp 16–33
Thurel C, Rey A, Thiébault JB, Chai N, Houdart R (1974) Anévrysmes carotid-ophtalmiques. Neuro-Chirurgie 20: 25–39
Xuereb GP, Prichard MML, Daniel PM (1954) The arterial supply and venous drainage of the human hypophysis cerebri. Quart J exp Physiol 39: 199–217
Yasargil MG, Gasser JC, Hodosh RM, Rankin TV (1977) Carotid-ophthalmic aneurysms: direct microsurgical approach. Surg Neurol 8: 155–165
YaŞargil MG (1984) Microneurosurgery II. Thieme, Stuttgart New York, pp 43–57
Yamada K, Hayakawa T, Oku Y. Maeda Y, Ushio Y, Yoshimine T, Kawai R (1984) Contralateral pterional approach for carotidophthalmic aneurysm: usefulness of high resolution metrizamide or blood computed tomographic cisternography. Neurosurgery 15: 5–8
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Gibo, H., Kobayashi, S., Kyoshima, K. et al. Microsurgical anatomy of the arteries of the pituitary stalk and gland as viewed from above. Acta neurochir 90, 60–66 (1988). https://doi.org/10.1007/BF01541268
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DOI: https://doi.org/10.1007/BF01541268