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InternalcarotidarteryocclusionandEvaluationofcollateralcirculation1 InternalcarotidarteryoccluCASEONE：Male,40yearsold,hospitalizedwiithspeechdifficultiesandone-sidelimbsweaknessfor4hours,4yearsHeadachehistory,physicalexaminations:musclestrengthgrades(MSG)isIII.NIHSSscoreis6.MRI（seechartbelow），），abnormalbloodlipidlevel。2 CASEONE：Male,40yearsold,hQuestion：Reasonofsmallinfarctsize？Reason ofocclusion？Howtodeal？3Question：34455Reason:CollateralcirculationNoatherosclerosisplaque.HeadachehistoryConclusion:ArteryDissection6Reason:Collateralcirculation6ArteryDissection7ArteryDissection7Treatment:High-operative-riskWell-developedcollateralcirculationConclusion：non-operativetreatments8Treatment:8ImportantanceofcollateralcirculationDiagnosis.Treatment.Prognosisandrisk.9ImportantanceofcollateralciNocollateralcirculation:10Nocollateralcirculation:10Internalcarotidarteryocclusion1：Chronicocclusion2：Acuteocclusion1）Collateralcirculation2）NocollateralcompensationSevereclinicalsymptoms?=11InternalcarotidarteryocclusReview：12Review：12Which？WillsArterialnetworkofthepiamater（皮层软膜（皮层软膜代偿）代偿）Others（肌支及（肌支及ECA）13Which？Wills13Wills：1：Posteriorcommunicatingartery（PCoA）2：Anteriorcommunicatingartery（ACoA）3：A1segmentofanteriorcerebralartery（A1）4：P1segmentofposteriorcerebralartery（P1）5：supraclinoidsegmentoftheinternalcarotidartery14 Wills：1：PosteriorcommunicatDSA：Wills15DSA：Wills15Arterialnetworkofthepiamater：前交通动脉代前交通动脉代/额顶叶来源于患侧额顶叶来源于患侧大脑前动脉软膜吻合大脑前动脉软膜吻合，16ArterialnetworkofthepiamaOthers:1 1：Facial arteryFacial artery（面动脉）（面动脉）2 2：Superficial temporal arterySuperficial temporal artery （颞浅动脉）（颞浅动脉）3 3：Middle meningeal arteryMiddle meningeal artery （脑膜中动脉）（脑膜中动脉）4 4：Posteriorcommunicatingartery （后交通动脉）（后交通动脉）5 5：Foramen artery Foramen artery（圆孔动脉）（圆孔动脉）6 6：Ascending pharyngeal Ascending pharyngeal artery artery （咽升动脉）（咽升动脉）7 7：Occipital artery Occipital artery（枕动脉）（枕动脉）8：Ascendingcarotidartery（颈升动脉）（颈升动脉）10：SuperiorthyroidarteryInferiorthyroidartery （甲状腺上下动脉）（甲状腺上下动脉）17Others:1：Facialartery（面动脉）17DSA：18DSA：18Circulation：19Circulation：19Collateralcirculation：EncirclingthecitiesfromruralareasSupplyingthegovernmentfromborderareas.20Collateralcirculation：20THANKYOU21 21
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