Study Of Collateral Circulation Variation And The Relationship Between Collateral Circulation And Prognosis In Patients With Acute Cerebral Infarction Of Middle Cerebral Artery Territory

Part 1 collateral circulation variation of acute cerebral infarction of middle cerebral artery territoryObjective:To observe coilateral circulation variation of acute cerebral infarction of middle cerebral artery(MCA)territory.Method:We studied sixty-five patients with acute cerebral infarction of MCA territory and collected the basic information.The patients were divided into three groups as stem branch,cortical branch and perforating branch.Fifty healthy persons were selected as control group.All subjects were examined by transcranial doppler ultrasonography(TCD)and time-of-flight magnetic resonance angiography(tofMRA).The data was analysed with SPSS statistic software.Result:(1)On TCD findings,the blood flow velocity ratios of anterior cerebral artery(ACA)for lesion side to the other in patient group was higher than ratios in controls,there was a significant difference between the two groups(p＜0.01);There was no statistical difference for the ratios of posterior cerebral artery(PCA)between the two groups(p＞0.05).(2)On tofMRA findings,in the 65 patients,the DIPCA phenomenon for PCA of lesion side longer or thicker than the other occurred in 24 patients,the rate was 36.92%;the length ratios of PCA for lesion side to the other in patient group was not higher than ratios in controls,there was no statistical difference between the two groups(p＞0.05);There was neither statistical difference for the diameter ratios of PCA between the two groups(p＞0.05).(3)It was sensitive for TCD to examine ACA compensation,it was easy for tofMRA to observe DIPCA phenomenon.(4)In patient group,on TCD and tofMRA findings,the compensation ablity of collateral circulation from the best to the worst were stem branch,cortical branch and perforating branch.Conclusion:In patients with acute cerebral infarction of MCA territory,ACA was the primary collateral circulation,PCA compensation existed only as a part;it was primary for TCD to examine ACA compensation,it was easy for tofMRA to observe PCA compensation;the compensation ablity of brain blood flow from the best to the worst were stem branch,cortical branch and perforating branch infarction.Part 2 Study of the relationship between collateral circulation and prognosis in patients with acute cerebral infarction of middle cerebral artery territoryObjective:To analyse the relationship between collateral circulation and prognosis in patients with acute cerebral infarction of MCA territory.Method:We studied sixty-five patients with acute cerebral infarction of MCA territory and collected the basic information.The patients were divided into three groups as stem branch,cortical branch and perforating branch.Stroke severity of all patients was measured with National Institutes of Health Stroke Scale(NIHSS)on admission,at the three-month visits.The data was analysed with SPSS statistic software.Result:(1)In patient group,on TCD findings,the prognosis for the patients with ACA compensation was better than with PCA compensation(p＜0.01);the prognosis for the patients with ACA and PCA compensation was better than with ACA compensation(p＜0.01).(2)In patient group,on tofMRA findings,the prognosis for the patients with DIPCA phenomenon was better than the patients without DIPCA phenomenon(p＜0.05).(3)the prognosis for the patients with cortical branch infarction was better than the two other groups(p＜0.05).Conclusion:In patient group,the prognosis for the patients with cortical branch infarction was comparatively better;the prognosis for the patients with sufficient collateral circulation was comparatively better.