CVD 浙大英文课件.doc

深穿支动脉为出血的主要部位，豆纹动脉是脑出血最好发部位，其外侧支称为出血动脉 The mainly hemorrhagic sites are the perforating branches of middle cerebral artery, the most common sites of ICH are lenticulostriate arteries, lateral branches of those are called hemorrhagic arteries. 基底节区 Basal ganglia 70% 脑叶 Cerebral lobe 10% 脑干 Brain stem 10% 小脑齿状核区 Cerebellar dentate nucleus 10% 粟粒状动脉瘤:大脑中动脉深穿支豆纹动脉基底动脉脑桥支大脑后动脉丘脑支小脑上动脉分支顶枕交界区和颞叶分支 Granulous aneurysm : the lenticulostriate arteries branches of the basilar artery supplying the pons thalamic branches of the posterior cerebral arteries branches of the superior cerebellar arteries some arteries supplying the junctional zone between parietal and occipital lobe and branches of temporal lobe 临床表现 clinical manifestations (1) 年龄50-70岁，男女 Age 50-70 years. The incidence is higher in men than in women 冬春季多发 Mostly occurrs in winter and spring. 多有高血压史 Usually with hypertension. 活动或情绪激动时发生 Occurrs when activities or emotional excitement. 数分钟至数小时症状达高峰 Neurologic deficits may progress over minutes to hours. 全脑症状：头痛、呕吐、意识改变 Global cerebral symptom: headache, vomiting, alterd consciousness 临床表现 clinical manifestions (2) 1. 基底节区出血（内囊区出血）占70%，其中壳核（内囊外侧型）60%，丘脑（内囊内侧型）10%。 The most common site of hemorrhage is basal ganglia, which occurs in 70% of patients. It consists of putamen (lateral of the internal capsule) and thalamus (medial of the internal capsule) . (1)壳核出血：三偏，双眼向病灶对侧同向凝视不能，主侧半球有失语。 (1) Putaminal hemorrhage: hemiplegia, hemisensory deficit, hemiopia, impairment of syntropic gaze to the contralateral lesion, aphasia with dominant hemisphere 临床表现 clinical manifestions (3) (2)丘脑出血：丘脑膝状动脉和丘脑穿通动脉。三偏，上下肢程度相近，深浅感觉障碍，特征性眼征，意识障碍，中线症状，锥体外系症状，丘脑性失语，精神症状。 (2)Thalamic hemorrhage: the thalamic genual artery and the long penetrating thalamic artery. hemiplegia, hemisensory deficit, hemiopia, hemiplegia affecting the arm and leg to a roughly equal extent, impairment of superficial and deep sensation, marked ocular sign, impai