脑储蓄英文PPT.ppt

Treatment and prognosis Same to the arterothrombotic cerebral infarction, but need not thrombolysis, anticoagulation, decrease the blood pressure, dehydrate. Prognosis is not so bad, most patients can recover soon. But it may happen again and again, then pseudobulbar palsy (假性球麻痹)and vascular dementia may be induced. Part four cerebral watershed infarction (脑分水岭梗死) Etiology and pathology Border zone infarction: the infarction zone located between the territories supplied by two arteries close together. Narrow of the cerebral artery + abnormal of haemodynamics (decrease of blood volume, low blood pressure) ?stroke, overdose of narcotic(麻醉药)，hypotensive (降压药),severe anhydration The most common site of CWSI is the zoon between MCA and PCA, the next common site is the zoon between ACA and MCA. Clinic findings Age:50y, History: hypertension, artherosclerosis, coronary artery disease, diabetes, hypotension, TIA history Onset: with low blood pressure, low blood volume Clinic findings Pre-cortex: mainly effect upper limb, hemiparalysis, hemi-sensory disturbance, with or without frontal lobe symptoms, such as psychiatric symptom, forced grasping reflex; trans-cortex ataxic aphasia (运动性失语 ), when the site located in the dominant hemisphere. (ACA MCA) Post-cortex: hemiablepsia is the most common physical sign，with or without sensory disturbance, hemiparesis; trans-cortex receptive aphasia (MCA PCA) Sub-cortex: hemiparalysis, hemi-sensory disturbance (basal ganglia, internal capsule, body of lateral cerebral ventrical) posterior circulation: cerebellar ataxia, conscious disturbance, contracted pupil, gazing at the contralateral of the site (anterior cerebellar artery superior cerebellar, brainstem ) Investigative study CT MRI TCD DSA Diagnosis and treatment 50y, low blood pressure or low blood volume, focal neural function defection, CT MRI shows infarction in bendiformis. Correct low blood volume low blood p