影像梗死部位推测责任供血血管.pptVIP

从影像梗死部位推测责任供血血管 北京天坛医院神经内科 杜万良 大脑前动脉 大脑前动脉 前交通动脉穿支 irregularity and narrowing of thesupracallosal branch of the pericallosal artery Narrowing of both cavernouspart of the internal carotid arteries and both middle cerebral arteries.Narrowing of the right pericallosal artery 胼胝体压部梗死，应该属于大脑后的一个分支供血 heubner动脉 heubner动脉 heubner动脉 丘脑膝状体动脉 Anterior thalamoperforating artery前丘脑穿通动脉（应该也叫丘脑结节动脉或者丘脑极动脉） 丘脑穿通动脉 双侧丘脑穿通动脉 双侧丘脑穿通动脉thalamoperforating artery .2.3.5.6.7.9.丘脑膝状体动脉，12.为丘脑膝状体动脉和脉络膜后动脉分布区 15.丘脑膝状体动脉;16.丘脑结节动脉;18.双侧丘脑结节动脉;19.上：丘脑结节动脉，下：丘脑穿通动脉;20.脉络膜后动脉;21.丘脑穿通动脉 Schematic view of the arterial supply to the thalamus Figure 1. (A) Lateral view; (B) view from above; (C, D) detailed relationship between the arterial territories and nuclear subgroups within the thalamus. 1 =carotid artery; 2 =posterior communicating artery; 3 =basilar artery; 4 =thalamogeniculate arteries; 5 =tuberothalamic artery; 6 =posterior choroidal artery; 7 =paramedian pedicle; 8 =posterior cerebral artery. Main thalamic nuclei and tracts: CL =central lateral; CM =centromedian;Co =commissural; Cp =commissural posterior;DM =dorsomedian; MTT =mamillothalamic tract; Pua=pulvinar anterior; Pum =pulvinar medial; Pul =pulvinar lateral; Pf =parafascicularis; R =reticular; VA =ventral anterior; VLa = ventral lateral anterior; VLp =ventral lateral posterior; VPLa = ventroposterolateral anterior;VPLp = ventroposterolateral posterior; VPM =ventroposteromedian. Figure 2. (A) Diffusion-weighted MRI of a left anterior thalamic infarct involving the anterior nuclei and mamillothalamic tract in a 58-year-old patient who presented with perseverations, incoherent speech with intrusion of previous topics, and distorted memories. (B) Schematic representation (see figure 1 for legend) Figure 3. (A) T2-weighted MRI showing a bilateral paramedian stroke predominantly on the left side in a 39-yearold woman. This patient presented with improper behavior and inadequate and disinhibited comments to her husband