醫(yī)學(xué)課件-頸內(nèi)動(dòng)脈閉塞與側(cè)枝循環(huán)課件

1、Internal carotid artery occlusionand Evaluation of collateral circulation 1 Internal carotid artery occluCASE ONE：Male, 40 years old, hospitalized wiith speechdifficulties and one-sidelimbs weakness for 4 hours, 4 years Headache history , physicalexaminations:musclestrengthgrades(MSG) is III. NIHSS

2、score is 6.MRI（seechartbelow），abnormal blood lipid level。2 CASE ONE：Male, 40 years old, hQuestion： Reason of small infarctsize？Reason of occlusion？How to deal？3Question：34455Reason:Collateral circulationNo atherosclerosisplaque.Headache historyConclusion: ArteryDissection6Reason:Collateral circulati

3、on6ArteryDissection7ArteryDissection7Treatment:High-operative-riskWell-developedcollateral circulationConclusion ： non-operative treatments8Treatment:8Importantance of collateral circulationDiagnosis.Treatment.Prognosis and risk.9Importantance of collateral ciNo collateral circulation:10No collatera

4、l circulation:10Internal carotid artery occlusion 1：Chronic occlusion2：Acute occlusion 1） Collateral circulation 2） No collateral compensation Severe clinical symptoms ?=11Internal carotid artery occlusReview：12Review：12Which？Wills Arterialnetworkofthepiamater（皮層軟膜代償）Others（肌支及ECA）13Which？Wills 13Wi

5、lls：1： Posterior communicating artery（PCoA）2： Anterior communicating artery（ACoA）3： A1 segment of anterior cerebral artery（A1）4： P1 segment of posterior cerebral artery（P1）5：supraclinoid segment of the internal carotid artery14 Wills：1： Posterior communicatDSA：Wills15DSA：Wills15Arterialnetworkofthep

6、iamater ：前交通動(dòng)脈代/額頂葉來源于患側(cè)大腦前動(dòng)脈軟膜吻合，16ArterialnetworkofthepiamaOthers:1：Facial artery（面動(dòng)脈）2：Superficial temporal artery （顳淺動(dòng)脈）3：Middle meningeal artery （腦膜中動(dòng)脈）4： Posterior communicating artery （后交通動(dòng)脈）5： Foramen artery（圓孔動(dòng)脈）6： Ascending pharyngeal artery （咽升動(dòng)脈）7： Occipital artery（枕動(dòng)脈）8： Ascending carotid artery （頸升動(dòng)脈）10： Superior thyroid artery Inferior thyroid artery （甲狀腺上下動(dòng)脈）17Others:1：Facial artery（面動(dòng)脈）17DSA：18DSA：18Circulation：19Circulation：19Collateral circulation ：Encirclingthec