颈动脉闭塞患者脑梗死类型及侧支循环关系分析

Analysis the relationship between infarct pattern and collateral circulation in patients with internal carotid artery occlusion

目的:探讨颈内动脉闭塞(ICAO)患者的梗死类型及其与侧支循环的关系。方法:分析经脑血管造影证实为ICAO的27例脑梗死患者的头颅核磁共振、脑血管造影及经颅多普勒结果。结果:8例(29.6%)为单发梗死,19例(70.4%)为多发性梗死。皮层区域梗死6例(22.2%),皮质下梗死10例(37.0%),弥散性梗死7例(25.9%),交界区梗死8例(29.6%)。侧支循环途径包括经前交通动脉代偿14例,经后交通动脉代偿10例,经眼动脉代偿6例,经软膜吻合8例。8例单发梗死中,6例有2种代偿方式,2例有1种代偿方式,而19例多发梗死中,仅5例有2种代偿方式,14例有1种代偿方式。结论:ICAO患者的梗死类型有多种表现,以皮质下梗死和交界区梗死多见,且ICAO发生后有多种侧支循环途径代偿颅内供血,其中,单发梗死的代偿途径可能较多。

Objective： To study the infarct pattern in patients with internal carotid artery occlusion（ICAO） and analyse the relationship between infarct pattern and collateral circulation.Methods： the MRI,DSA and TCD results of 27 patients with cerebral infarction who were confirmed ICAO by DSA were analyzed.Results： 8 cases（29.6%） were single infarction,19 cases（70.4%） were multiple infarction.6 cases（22.2%） were cortical infarct,10 cases（37.0%） were subcortical infarct,7 cases（25.9%） were diffused infarct and 8 cases（29.6%） were interfacial infarct.In the ways of collateral circulation,14 cases were compensated by anterior communicating artery,10 cases by posterior communicating artery,6 cases by ophthalmic artery and 11 cases by pia mater.Among the 8 cases with single infarction,6 cases had two kinds of compensatory ways,2 cases had one kind of compensatory way,however among the 19 cases with multiple infarction,only 5 cases had two kinds of compensatory way,14 cases had one kind of compensatory way.Conclusion： The infarct pattern in patients with ICAO are various.Subcortical and nterfacial infarcts are the common pattern.There are various ways of collateral circulation to compensate the blood supplying of brain after ICAO,and the compensatory ways of single infarct are more than others.