颈内动脉闭塞与侧枝循环

InternalcarotidarteryocclusionandEvaluationofcollateralcirculationfengyuCASEONE：Male,40yearsold,hospitalizedwiithspeechdifficultiesandone-sidelimbsweaknessfor4hours,4yearsHeadachehistory,physicalexaminations:musclestrengthgrades(MSG)isIII.NIHSSscoreis6.MRI（seechartbelow），abnormalbloodlipidlevel。Question：•Reasonofsmallinfarctsize？•Reasonofocclusion？•Howtodeal？Reason:•Collateralcirculation•Noatherosclerosisplaque.•HeadachehistoryConclusion:ArteryDissectionArteryDissectionTreatment:•High-operative-risk•Well-developedcollateralcirculation•Conclusion：non-operativetreatmentsImportantanceofcollateralcirculationDiagnosis.Treatment.Prognosisandrisk.Nocollateralcirculation:Internalcarotidarteryocclusion1：Chronicocclusion2：Acuteocclusion1）Collateralcirculation2）NocollateralcompensationSevereclinicalsymptoms?=Review：Which？•Wills•Arterialnetworkofthepiamater（皮层软膜代偿）•Others（肌支及ECA）Wills：1：Posteriorcommunicatingartery（PCoA）2：Anteriorcommunicatingartery（ACoA）3：A1segmentofanteriorcerebralartery（A1）4：P1segmentofposteriorcerebralartery（P1）5：supraclinoidsegmentoftheinternalcarotidarteryDSA：WillsArterialnetworkofthepiamater：前交通动脉代/额顶叶来源于患侧大脑前动脉软膜吻合，Others:1：Facialartery（面动脉）2：Superficialtemporalartery（颞浅动脉）3：Middlemeningealartery（脑膜中动脉）4：Posteriorcommunicatingartery（后交通动脉）5：Foramenartery（圆孔动脉）6：Ascendingpharyngealartery（咽升动脉）7：Occipitalartery（枕动脉）8：Ascendingcarotidartery（颈升动脉）10：SuperiorthyroidarteryInferiorthyroidartery（甲状腺上下动脉）DSA：Circulation：Collateralcirculation：EncirclingthecitiesfromruralareasSupplyingthegovernmentfromborderareas.THANKYOU