頸內(nèi)動(dòng)脈閉塞與側(cè)枝循環(huán)

Internalcarotidarteryocclusion

andEvaluationofcollateralcirculationfengyuCASEONE：Male,40yearsold,hospitalizedwiithspeech

difficultiesand

one-side

limbsweaknessfor4hours,4yearsHeadachehistory,physical

examinations:muscle

strength

grades

(

MSG)isIII.NIHSSscoreis6.MRI（see

chart

below），abnormalbloodlipidlevel。Question：Reasonofsmallinfarct

size？Reason

ofocclusion？Howtodeal？Reason:CollateralcirculationNoatherosclerosis

plaque.HeadachehistoryConclusion:Artery

DissectionArtery

Dissection

Treatment:High-operative-riskWell-developed

collateralcirculationConclusion：non-operativetreatments

ImportantanceofcollateralcirculationDiagnosis.Treatment.Prognosisandrisk.Nocollateralcirculation:Internalcarotidarteryocclusion

1：Chronicocclusion2：Acuteocclusion

1）Collateralcirculation2）Nocollateralcompensation

Severeclinicalsymptoms

?=Review：Which？WillsArterial

network

of

the

pia

mater（皮層軟膜代償）Others（肌支及ECA）Wills：

1：Posteriorcommunicatingartery（PCoA）

2：Anteriorcommunicatingartery（ACoA）

3：A1segmentofanteriorcerebralartery（A1）

4：P1segmentofposteriorcerebralartery（P1）

5：supraclinoidsegmentoftheinternalcarotidarteryDSA：WillsArterial

network

of

the

pia

mater：前交通動(dòng)脈代/額頂葉來(lái)源于患側(cè)大腦前動(dòng)脈軟膜吻合，Others:1：Facialartery（面動(dòng)脈）2：Superficialtemporalartery

（顳淺動(dòng)脈）3：Middlemeningealartery

（腦膜中動(dòng)脈）4：Posteriorcommunicatingartery

（后交通動(dòng)脈）5：Foramenartery（圓孔動(dòng)脈）6：Ascendingpharyngealartery（咽升動(dòng)脈）7：Occipitalartery（枕動(dòng)脈）8：Ascendingcarotidartery

（頸升動(dòng)脈）10：SuperiorthyroidarteryInferiorthyroidartery（甲狀腺上下動(dòng)脈）DSA：Circulation：Collateralcirculat