目的：通过研究人脑基底动脉的显微解剖，包括脑基底动脉的形态、直径、长度、分支等的解剖特点，结合各种相关的显微神经外科手术入路等研究，探讨人脑基底动脉的显露特点及操作的难易程度，为临床治疗该区域的病变提供参考。方法：分为三部分。第一部分是改良传统的标本保存方法，比较新方法与传统方法保存期间的挥发性和实用性。第二部分为基底动脉显微解剖研究，将六具头颅标本于手术显微镜下(×7倍)观察基底动脉主干起止水平、直径大小、长度、椎动脉汇合角度等及其各分支如大脑后动脉(PCA)、小脑上动脉(SCA)、小脑前下动脉(AICA)等的发出角度、直径、相互间距等解剖学数据。第三部分为基底动脉相关的手术入路研究。按真实步骤模拟该部位相关手术入路(翼点入路、颞下经小脑幕入路、乙状窦前入路、枕下乙状窦后入路、远外侧入路、经口入路等)，比较不同手术入路的显露情况，测量各自到基底动脉顶端、中点、椎-基底动脉汇合部等不同部位的距离，并行统计分析。结果：新的保存方法比传统保存方法具有低挥发性，且适合显微神经解剖研究。脑底Willis环本身有很多变异。如本组发现一例大脑后动脉直接由颈内动脉发出，脑基底动脉分支有小脑上动脉的发出双干等。基底动脉上中段直径之间对比无统计学差异。各种手术入路中暴露基底动脉顶端的最短距离为经翼点入路，其次为颞下经小脑幕入路和乙状窦前入路；暴露基底动脉中段依次为经口入路，乙状窦前入路，颞下经小脑幕入路；暴露下段依次是经口入路，远外侧入路，乙状窦前入路，枕下乙状窦后入路距离最长。结论：应根据不同的病变部位，采用不同的手术入路。每种手术入路都有其固有的优缺点，应扬长避短，个体化设计，争取用最小的损伤获得最大最好的显露和治疗效果。 关键词：脑基底动脉 显微解剖 手术入路

 Object: Through study on neurosurgical microanatomy of basilar artery of cranial cadaver including its morphous, diameter, length and perforators, several related surgical approaches were utilized to reveal the basilar artery under neurosurgical microscope(×7). The condition of distance and revealing extent could be recorded in order to guide the clinical treatment. Methods: Firstly, the preservative procedure of cadaver was developed. The evaporability and practicality of new procedure was contrasted with them of traditional preservative procedure. Secondly, several basilar arteries of cranial cadaver were measured and microanatomical data were collected. Thirdly, several related neurosurgical approaches were performed step by step on the reality operational procedure such as the petrional approach, subtemporal transtentorial approach, presigmoid approach, suboccipital retrosigmoid approach, far lateral approach, transoral transclival approach. The revealing condition of several related approaches were contrasted each other and the distance were measured and analyzed statistically. Results: The new preservative procedure had low-level evaporability and was fit to the neurosurgical microanatomical research. There were several variants in the Willis circle of cranial base. In our study, one posterior cerebral artery was arising directly from the internal carotid artery. Double-trunk superior cerebellar artery was observed. However, there was no statistical difference of the diameter between the upper and meddle segment of basilar artery. In the several related neurosurgical approaches, the shortest distance of revealing the apex of basilar artery was the pterional approach, the next was the subtemporal transtentorial approach and the presigmoid approach. The shortest distance of exposing the middle trunk of basilar artery was the transoral transclival approach, the next was the presigmoid approach, the longest was the subtemporal transtentorial approach. The shortest distance of disclosing the vertebrobasilar junction was the transoral transclival approach, the next was the far lateral approach, the next was the presigmoid approach and the longest was the suboccipital retrosigmoid approach. Conclusion: According to the different lesion locations, the optimal neurosurgical approaches should be chosen. Exposure is everything. Every approach has its advantage and disadvantage. The fittest treatment should be individually tailored to every patient by all factors and minimal retraction of the brain or cranial nerve and maximal exposure and therapeutic effect should always be pursuit. Keywords: basilar artery microanatomy neurosurgical approach