颈内动脉闭塞与侧枝循环

Internal carotid artery occlusionand Evaluation of collateral circulation,fengyu,CASE 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 score is 6.MRI（seechartbelow），abnormal blood lipid level。,Question：,Reason of small infarctsize？Reason of occlusion？How to deal？,Reason:,Collateral circulationNo atherosclerosisplaque.Headache historyConclusion: ArteryDissection,ArteryDissection,Treatment:,High-operative-riskWell-developedcollateral circulationConclusion ： non-operative treatments,Importantance of collateral circulation,Diagnosis.Treatment.Prognosis and risk.,No collateral circulation:,Internal carotid artery occlusion,1：Chronic occlusion2：Acute occlusion 1） Collateral circulation 2） No collateral compensation,Severe clinical symptoms ?,=,Review：,Which？,Wills Arterialnetworkofthepiamater（皮层软膜代偿）Others（肌支及ECA）,Wills：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 artery,DSA：Wills,Arterialnetworkofthepiamater ：,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：Facial artery（面动脉）2：Superficial temporal artery （颞浅动脉）3：Middle meningeal artery （脑膜中动脉）4： Posterior communicating artery （后交通动脉）5： Foramen artery（圆孔动脉）6： Ascending pharyngeal artery （咽升动脉）7： Occipital artery（枕动脉）8： Ascending carotid artery （颈升动脉）10： Superior thyroid artery Inferior thyroid artery （甲状腺上下动脉）,DSA：,Circulation：,Collateral circulation ：,En