顱角動(dòng)歟粥樣硬牝性狹窄的治療高山北京協(xié)和醫(yī)院神經(jīng)內(nèi)科顱角動(dòng)歟粥樣硬牝性狹窄1LMCA大動(dòng)麻粥樣硬化咝狹窄LCCA發(fā)觀顱內(nèi)動(dòng)丁應(yīng)怎么力?HeartLMCA2無(wú)癥狀性顱動(dòng)脈狹窄?無(wú)癥狀性顱動(dòng)脈狹窄?3對(duì)無(wú)魂?duì)铒B內(nèi)動(dòng)國(guó)際國(guó)內(nèi)沒(méi)有一項(xiàng)指南建議支架治療!為什么?對(duì)無(wú)魂?duì)铒B內(nèi)動(dòng)4無(wú)癥狀大腦中動(dòng)脈粥樣硬化性狹窄發(fā)生卒中的風(fēng)險(xiǎn)20194FJournaloftheNeurologicalSciencesburnsih6m悉ww在在DC門(mén)作StrokeriskandprognosticfactorsofasymptomaticmiddlecerebralarteryInNi,MingYaoShanGao,Li-yingCui2019年-2019年入組,北京協(xié)和醫(yī)院神經(jīng)科TCD檢查室TCD篩查MCA狹窄:224例TCD+MRA:87例13例TCD與MRA不相待,剔TCD+重復(fù)TCD:137例一11例兩次TCD不一致,剔除最后納入研究:200例NiJ,YaoM,GaoS,CuiLYStrokeriskandprognosticfactorsofasymptomaticmiddlecerebralarteryatheroscleroticsteNeurolsci.2019Feb15:301(1-2);63無(wú)癥狀大腦中動(dòng)脈粥樣硬化性狹窄發(fā)生卒中的風(fēng)險(xiǎn)5平均隨訪38個(gè)月(4-64個(gè)月)7例卒中第1年0.5%第2年1.6%累計(jì)3.8%MCA狹窄相關(guān)卒中3年累計(jì)3/200(1.5%)3例與無(wú)癥狀MCA狹窄相關(guān)3例對(duì)側(cè),1例后循環(huán)說(shuō)明,天癥狀大腦中動(dòng)腺捩窄沒(méi)生亭中風(fēng)險(xiǎn)很低平均隨訪38個(gè)月(4-64個(gè)月)6splaysettings:()Abstract2019,JNeurolNeurosurgPsychiatrySendto回OShowingresultsforprogneneurosurgpsychiatryasmatomafcstennsismMaumsumPsychiatr10)JNeurelNeurosurgPsychiatry.2019Sep:Ts(9:13DD-3.Prognosisofasymptomaticstenosisofthemiddleeoac隨訪2年KramEr.SrhanttinLGsomiadisnBaumgartnERRWDepartmentoffleurobgy,UniversityHostaofZurich,Switzerlandchrstine.kremengnchmaumt-hedelbergde無(wú)MCA相關(guān)卒中50例無(wú)癥狀大腦中動(dòng)脈粥樣硬化性狹窄TCCD診斷平均隨訪815天(2年多)沒(méi)有1例在無(wú)癥狀MCA狹窄區(qū)域發(fā)生卒中DisplaySettings:AbstractMCA相關(guān)年卒中see1articlefoundusinganalternativesearch2019年,NeurologyStrokerecurrencesinpatientswithsymptomativsasymptomaticmidd險(xiǎn)1.4%cernneuro.ma.unkheece56例無(wú)癥狀大腦中動(dòng)脈粥樣硬化性狹窄TCD+TCCD診斷年卒中風(fēng)險(xiǎn)2.8%,發(fā)生在狹窄MCA的風(fēng)險(xiǎn)1.4%說(shuō)明,天癥狀大腦中動(dòng)腺捩窄沒(méi)生亭中風(fēng)險(xiǎn)很低splaysettings:()Abstract7那么。物優(yōu)冬品定默MCA管中網(wǎng)險(xiǎn)會(huì)這無(wú)狀mc換窄據(jù)塊穩(wěn)定DisplaySettinng()Abstract2019年的一篇小文章articlefoundusinganalternativesearch:JNeuomanre4D01-pr,112:Apilotstudyofmicroembolicsignalsinpatientswithmiddlecerebralarterystenosis.Lanwchal,不到20例無(wú)癥狀MCA狹窄病人未監(jiān)測(cè)到MESMES發(fā)生頻率動(dòng)脈源性栓子源臨床病人總數(shù)再發(fā)卒中風(fēng)險(xiǎn)范圍ICA狹窄有癥狀42%18-100%有關(guān)無(wú)癥狀18262-29%有關(guān)顱內(nèi)動(dòng)脈狹窄有癥狀18322-75%有關(guān)無(wú)癥狀無(wú)研究主動(dòng)脈弓有癥狀8832%13-48%無(wú)研究那么。物優(yōu)冬品定默MCA管中網(wǎng)險(xiǎn)會(huì)這8那么。物優(yōu)冬品定默MCA管中網(wǎng)險(xiǎn)會(huì)這無(wú)淀狀m換窄塊穩(wěn)定癥狀性T1,斑塊內(nèi)出血更偏心錢(qián)選塊和擴(kuò)張性量構(gòu)Fit2FRauumesdantmetomauc國(guó)noocytm基an(ow.B)onconservewathabntdwighta(lonanov,CantDnisseenmthr無(wú)癥狀性癥狀性狹窄:9/46無(wú)癥狀性狹窄:2/63更多縮華性重構(gòu)XUWH,LIML,GAoS,etaXUWH,LIML,GAoS,etAtherosclerosis2019.212.507-511AnnNeurol.2019:;71(2):195-8那么。物優(yōu)冬品定默MCA管中網(wǎng)險(xiǎn)會(huì)這9那么。物優(yōu)冬品定默MCA管中網(wǎng)險(xiǎn)會(huì)這無(wú)癥狀m狹窄塊穩(wěn)定NO-MES高分辨磁共振縮窄性重構(gòu)斑塊內(nèi)出血非常少見(jiàn)解釋覬家:無(wú)癥狀大腦中動(dòng)脈毀生卒中險(xiǎn)假低那么。物優(yōu)冬品定默MCA管中網(wǎng)險(xiǎn)會(huì)這10顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件11顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件12顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件13顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件14顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件15顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件16顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件17顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件18顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件19顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件20顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件21顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件22顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件23顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件24顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件25顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件26顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件27顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件28顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件29顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件30顱內(nèi)動(dòng)脈粥樣硬化性狹窄的治療課件31顱內(nèi)動(dòng)脈粥樣硬化性