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1、Cerebrovascular DiseasesXueQunDepartmentofNeurologyTheFirstAffiliatedHospitalofSoochowUniversity第一节outline（概述）keyconceptsCerebrovasculardiseases:thefocalordiffusedfunctiondisordersofthebrain,onthebasicdisorderofthecerebralvascularwallorofthebloodflow
2、Type:Accute:TIA(transientischemicattack)StrokeChronic:CerebrovasculardementiaStroke（apoplexy/cerebrovascularaccident）:asyndromecharacterizedbytheacuteonsetofaneurologicdeficitthatpersistsforatleast24hours,reflectsfocalinvolvementofthecentralnervoussy
3、stem,andistheresultofadisturbanceofthecerebralcirculation.Types:ischemia:localthrombosisorembolizationfromadistantsitehemorrhage：Strokeischemia:Cerebralischemicstroke(cerebralinfarction)arterothromboticinfarctionCerebralembolismLacunarinfarctionhemor
4、rhage：CerebralhemorrhageSubarachnoidhemorrhageTerritoriesoftheprincipalcerebralarteriesAnteriorcirculationInternalcarotidarteryOphthalmicarteryposteriorcommunicatingarteryAnteriorchoroidalartery(hippocampus,globuspallidus,lowerinternalcapsule)Anterio
5、rcerebralartery(medialfrontal额叶andparietal顶叶cortexandsubjacentwhitematter,anteriorcorpuscallosum胼胝体)Middlecerebralartery(lateralfrontal,parietal,occipital,andtemporal颞叶cortexandsubjacentwhitematter)Lenticulostriatebranches(caudatenucleus尾状核,putamen壳核
6、,upperinternalcapsule)TerritoriesoftheprincipalcerebralarteriesPosteriorcirculationVertebralarteryPosteriorinferiorcerebellar(medulla,lowercerebellium)BasilararteryAnteriorinferiorcerebllar(lowerandmidpons,midcerebellium)Superiorcerebellar(upperpons,
7、lowermidcerebellum)Posteriorcereballar(medialoccipitalandtemporalcortexandsubjacentwhitematter,posterriorcorpuscallosum胼胝体,uppermidbrain)Thalamoperforatebranches丘脑穿通动脉(thalamus)Thalamogeniculatebranches丘脑膝状体动脉(thalamus)Pathology,physiologyandbloodcir
8、culationregulationWeightofbrainis1.5kg,about2~3%ofbodyweightCBF750~1000ml/min(CBF∞CPP/CVR)Cerebralbloodflow∞cerebralperfusionpressure/cerebralvascularresistanceCBF=(MAC-ICP)πr4/(8η*L)MAC(平均动脉压)，ICP（颅内压),r(caliber管径)，η（bloodviscosity血黏度），L（血管长度）第二节Epi
