脑血管病总论-第四军医大学唐都医院神经外科王学廉.pptVIP

血栓的病人可选择溶栓治疗 历史上有许多的名人曾经被动脉瘤所困扰，著名的小品艺术家赵本山，曾经在上海华山医院进行过动脉瘤栓塞术。 * * A. Axial T2-weighted and coronal T1-weighted magnetic resonance imaging shows a large mixed-signal intensity mass in the posterior fossa compressing the pons. B. Left vertebral angiogram, lateral view, during manual left carotid compression. Fusiform aneurysm of left vertebral artery (straight arrows) begins just distal to the origin of the posterior inferior cerebellar artery (curved arrow). 颈内动脉眼段动脉瘤 * * 对于颅内巨大动脉瘤，小动脉瘤，或者长的部位不适合栓塞，患者经济不宽裕的可开颅夹闭，彻底治愈。 畸形团的的病变 Onyx胶是畸形栓塞很好的材料 不粘管，弥散性好，使脑动静脉畸形介入治疗前进了一大步，有效减少的复发率及并发症 Confidential Onyx 及输送系统 Equinox?, HyperGlide? and HyperForm? Occlusion Balloons SilverSpeed? X-pedion? Hydrophilic Guidewires Rebar? Micro Catheter Cadence Precision Injector? for Balloon 震荡Onyx 胶 警告: 如果没有对Onyx 胶充分加热、混合，则可能在Onyx胶传送过程中显影不清。 AVM栓塞前 栓塞后 半年后复查 一年后复查 畸形团小，无明显供血动脉，直接手术切除 术后 放疗治疗 1-3年才能起效，但对于3cm的AVM，能大大降低出血的发生率；对于较大的畸形团也能明显降低出血率，近期报导：采取多次，低剂量放疗，对巨大AVM效果也比较明显。 近期并发症，多为一过性（5％左右），晚期持久并发症更低，与照射的范围与剂量有关系。 首先进行栓塞，残留部分行伽玛刀治疗 栓塞前 栓塞后 AVM栓塞治疗并发症 出血 栓塞 粘管 滞管 随着我们技术的不断改进，颅内血管病的治疗将日趋完美，相信一定会造福于更多的患者！ 这些知识你明白了吗？ 主要的脑血管有哪些？ 颈内动脉的作用有哪些？ 支架治疗后为啥仍要服药？ 溶栓的时机？ 支架置入术后的注意事项？ * External Carotid artery(ECA) - arises from CCA bifurcation as smaller of the two branches Internal Carotid artery(ICA) - begins at the bifurcation of the CCA at the C3 - C4 or C4 - C5 Level * External Carotid artery(ECA) - arises from CCA bifurcation as smaller of the two branches Internal Carotid artery(ICA) - begins at the bifurcation of the CCA at the C3 - C4 or C4 - C5 Level * The three major arteries at the base of the skull ( the two ICA and the BA) are connected to each other through an arterial network called the Circle of Willis The Circle of Willis includes the following branches: The Anterior Communicating Artery ( AComA) The Posterior Communicating Artery( PComA) The proximal (P1) segments of the Posterior Cerebral Arteries ( PCA) The most distal intra