EFFECT OF CHRONIC MIDDLE CEREBRAL-ARTERY STENOSIS ON THE LOCAL CEREBRAL HEMODYNAMICS
EFFECT OF CHRONIC MIDDLE CEREBRAL-ARTERY STENOSIS ON THE LOCAL CEREBRAL HEMODYNAMICS
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DOI：
10.1161/01.str.16.2.214
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发表时间：
1985-01-01
期刊：
影响因子：
8.3
通讯作者：
TAKAMIYA, M
中科院分区：
文献类型：
--
作者：
NARITOMI, H;SAWADA, T;TAKAMIYA, M
在 36 名经血管造影证实大脑中动脉 (MCA) 狭窄的患者中，采用血管造影、133Xe 吸入局部脑血流 (rCBF) 测量和 CT [计算机断层扫描] 扫描来研究局部脑血流动力学。其中8例出现短暂性脑缺血发作，28例完成卒中。狭窄率小于50%的患者（n = 16）在血管造影和rCBF检查中未发现血流动力学异常。本组梗塞面积较小，位于基底节区。狭窄程度为 50-74% 的患者 (n = 9) 经常在血管造影中发现 MCA 分支充盈延迟，但 rCBF 没有明显减少。该组的梗塞面积也较小，且位于基底神经节区域。 75-99% 狭窄的患者 (n = 11) 在血管造影和 rCBF 检查中均表现出明显的血流抑制。其中3人在分水岭区或大脑皮层出现大面积脑梗塞。 MCA 狭窄的血流动力学影响在等级 50% 时开始显现，在 75% 时变得明显。当MCA狭窄程度超过75%时，血流动力学危机的危险以及大面积脑梗塞的风险可能增加。
In 36 patients with angiographically proven middle cerebral artery (MCA) stenosis, local cerebral hemodynamics were studied employing angiography, 133Xe inhalation regional cerebral blood flow (rCBF) measurements and CT [computed tomography] scans. They had transient ischemic attacks in 8 and completed stroke in 28. The patients with less than 50% stenosis (n = 16) had no hemodynamic abnormality in angiographical and rCBF examinations. The infarction in this group was small and located in the basal ganglia area. The patients with 50-74% stenosis (n = 9) often revealed a delayed filling of MCA branches in the angiography, however, they showed no significant rCBF reduction. The infarction in this group was also small and located in the basal ganglia area. The patients with 75-99% stenosis (n = 11) exhibited a significant flow depression both in angiographical and rCBF examinations. Three of them had large cerebral infarction in the watershed zone or the cerebral cortex. The hemodynamic effect of MCA stenosis begins to manifest at 50% in grade and becomes apparent at 75%. The danger of hemodynamic crisis as well as the risk of large cerebral infarction may increase when MCA stenosis exceeds 75% in grade.