颈内动脉闭塞与侧枝循环

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：WillsArterial

network

of

the

pia

mater：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：Collateralcirculat