脑小血管病概念与治疗课件.pptxVIP

脑小血管病——概念与治疗杜万良北京天坛医院神经内科2014.11.15脑小血管注射硫酸钡的标本。白质中央血管密度低。Salamon, N., Neuroimaging of cerebral small vessel disease. Brain Pathol, 2014. 24(5): p. 519-24.脑小血管注射硫酸钡的标本。供应胼胝体的小分支。Salamon, N., Neuroimaging of cerebral small vessel disease. Brain Pathol, 2014. 24(5): p. 519-24.脑小血管病的分类腔隙综合征 腔隙综合征 脑小血管病的分类MR表现Wardlaw, J.M., et al., Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. The Lancet Neurology, 2013. 12(8): p. 822-838.急性腔梗的1年演变Wardlaw, J.M., C. Smith, and M. Dichgans, Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging. Lancet Neurol, 2013. 12(5): p. 483-97.腔隙常在 白质高信号边缘Duering, M., et al., Incident lacunes preferentially localize to the edge of white matter hyperintensities: insights into the pathophysiology of cerebral small vessel disease. Brain, 2013. 136(Pt 9): p. 2717-26.一名75岁男性，短暂性神经症状发作后1周出现症状性左侧额叶出血Charidimou, A., J.C. Baron, and D.J. Werring, Transient focal neurological episodes, cerebral amyloid angiopathy, and intracerebral hemorrhage risk: looking beyond TIAs. Int J Stroke, 2013. 8(2): p. 105-8.SVD score (range 0–4)男性(OR 1.58, 95% CI 1.10–2.29), 高血压(OR 1.50, 95% CI 1.02–2.20), 吸烟 (OR 2.81, 95% CI 1.59–3.63), 腔隙性卒中 (OR 2.45, 95% CI 1.70–3.54) 与SVDScore相关. 脑萎缩与SVDScore无关Staals, J., et al., Stroke subtype, vascular risk factors, and total MRI brain small-vessel disease burden. Neurology, 2014. 83(14): p. 1228-34.脑小血管病的分类一名CADASIL（伴皮质下梗死和脑白质病的常染色体显性遗传性脑动脉病）患者56岁和66岁的影像Salamon, N., Neuroimaging of cerebral small vessel disease. Brain Pathol, 2014. 24(5): p. 519-24.一名66岁的女性CADASIL患者Salamon, N., Neuroimaging of cerebral small vessel disease. Brain Pathol, 2014. 24(5): p. 519-24.COL4A1突变47岁无症状COL4A1突变患者（A,C,E,G,I,J）。57岁CADASIL患者。一名HERNS (伴有视网膜病-肾病-卒中的遗传性内皮细胞病)患者早期曾被误诊为多发性硬化Salamon, N., Neuroimaging of cerebral small vessel disease. Brain Pathol, 2014. 24(5): p. 519-24.一名HERNS患者的影像早期有占位效应和强化。Salamon, N., Neuroimaging of cerebral small vessel disease. Brain Pathol,