CIS分型课件.ppt

动脉到动脉 栓塞 载体动脉斑块 堵塞穿支 机制 大动脉粥样硬化缺血性卒中 多发、皮层或 区域性梗死 MES（+） 50% KS Wong, Gao S, Annals of Neurology 2002; 52: 74-81 30例MCA狭窄梗死 16例交界区梗死 TCD-MES 分水岭梗死往往伴随其他梗死类型 栓子清除下降：低灌注+动脉到动脉栓塞 50% MES 动脉到动脉 栓塞 载体动脉 堵塞穿支 机制 大动脉粥样硬化缺血性卒中 低灌注/ 栓子清除下降 分水岭梗死 机制：混合机制 （动脉到动脉栓塞+低灌注/栓子清除下降） 病因-颅内外大动脉粥样硬化 发病机制：混合机制 （载体动脉斑块堵塞穿支+ 低灌注/栓子清除下降） 混合机制：动脉到动脉栓塞+低灌注/栓子清除下降 动脉到动脉 栓塞 载体动脉斑块 堵塞穿支 机制 大动脉粥样硬化缺血性卒中 低灌注/ 栓子清除下降 混合机制 多发、皮层或 区域性梗死 MES（+） 分水岭梗死 穿支动脉孤立梗死 载体动脉粥样狭窄/斑块 大动脉粥样硬化 心源性 穿支动脉疾病 其他病因 病因不确定 多病因 无确定病因 动脉到动脉 栓塞 载体动脉斑块 堵塞穿支 低灌注/ 栓子清除下降 混合型 主动脉弓 颅内外 大动脉 检查欠完整 9H以上 * Stroke is a “Brain Attack.” Stroke happens in the brain not the heart Stroke is an emergency. Call 911 for emergency treatment. * Uncontrolled net shift of extracellular water Membrane channel failure - shift of extracellular water into intracellular space - CYTOTOXIC edema and irreversible damage Extent of core and penumbra depends on preexisting collaterals * * * Chen XY, Wong KS, Lam WW, Zhao HL, Ng HK. Middle cerebral artery atherosclerosis: histological comparison between plaques associated with and not associated with infarct in a postmortem study. Cerebrovasc Dis. 2008. 25(1-2): 74-80. Klein IF, Labreuche J, Lavallee PC, et al. Is moderate atherosclerotic stenosis in the middle cerebral artery a cause of or a coincidental finding in ischemic stroke. Cerebrovasc Dis. 2010. 29(2): 140-5. Lammie GA, Brannan F, Slattery J, Warlow C. Nonhypertensive cerebral small-vessel disease. An autopsy study. Stroke. 1997. 28(11): 2222-9. * Chen XY, Wong KS, Lam WW, Zhao HL, Ng HK. Middle cerebral artery atherosclerosis: histological comparison between plaques associated with and not associated with infarct in a postmortem study. Cerebrovasc Dis. 2008. 25(1-2): 74-80. Klein IF, Labreuche J, Lavallee PC, et al. Is moderate atherosclerotic stenosis in the middle cerebral artery a cause of or a coincidental finding in ischemic stroke. Cerebrovasc Dis. 2010. 29(2): 140-5. Lammie GA, Brannan F, Slattery J, Warlow C. Nonhypertensive cerebr