慢性单侧颈内动脉颅外段闭塞患者脑动脉血流分流观察

发布时间：2018-07-09 22:06

本文选题：颈内动脉闭塞 + 脑动脉血流分流　；参考：《山东医药》2017年43期

【摘要】：目的观察慢性单侧颈内动脉颅外段闭塞后,其远端的大脑前动脉(ACA)和大脑后动脉(PCA)向大脑中动脉(MCA)供血区域分流的情况。方法选择由磁共振血管成像和颈动脉血管超声检查证实的单侧慢性颈内动脉颅外段闭塞患者94例(左侧颈内动脉闭塞45例、右侧颈内动脉闭塞49例),采用彩色经颅多普勒超声仪检测其ACA、PCA、MCA的平均血流速度和搏动指数,据此判断是否有ACA、PCA向MCA供血区域分流的情况及软脑膜侧支循环开放情况。结果 94例患者中,患侧PCA向同侧MCA形成脑血流分流者47例、未形成脑血流分流者47例,患侧ACA向同侧MCA均未形成脑血流分流。依据脑血流分流的形成情况,判断患侧PCA与同侧MCA软脑膜侧支循环开放者47例,没有患侧ACA与同侧MCA软脑膜侧支循环开放者。结论慢性单侧颈内动脉闭塞患者具有患侧PCA向MCA供血区域分流的特征,没有明显的患侧ACA向MCA供血区域分流现象。
[Abstract]:Objective to observe the distal anterior cerebral artery (ACA) and posterior cerebral artery (PCA) shunt to the middle cerebral artery (MCA) after the occlusion of the extracranial segment of the unilateral internal carotid artery (ICA). Methods 94 patients (45 patients with left internal carotid artery occlusion) who were confirmed by magnetic resonance angiography and carotid artery ultrasound were selected. In 49 patients with right internal carotid artery occlusion, the average blood flow velocity and pulsatile index of ACAPCAA MCA were measured by color transcranial Doppler sonography. The results showed that there was a shunt from ACAPCA to the MCA supply area and the opening of collateral circulation to the pial meninges. Results among 94 patients, 47 cases had cerebral blood flow shunt from ipsilateral MCA, 47 cases had no cerebral blood flow shunt, and none of them had cerebral blood flow shunt from ACA to ipsilateral MCA. According to the formation of cerebral blood flow shunt, 47 cases with PCA and ipsilateral MCA pial meningeal collateral circulation were opened, but no ACA and ipsilateral MCA collateral circulation were opened. Conclusion the patients with chronic unilateral internal carotid artery occlusion have the characteristics of PCA shunt from the affected side to the MCA supply area, and there is no obvious shunt from the affected side ACA to the MCA supply area.
【作者单位】：华北理工大学附属开滦总医院;河北省神经生物机能重点实验室;唐山市神经病学重点实验室;
【基金】：河北省医学科学研究重点课题(20150839)
【分类号】：R445.1;R743.3

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