The Relationship Of Cerebral Infarction Position、the Internal Carotid Artery The Arteries And Middle Cerebral Artery

Purpose：Watershed infarction(WSI) is adjacent brain artery blood on the edge of the areawith happen between the cerebral infarction, is the special type of ischemiccerebrovascular disease of thrombosis in cerebral infarction. Its accounts for about10%of all cerebral infarction, disability and death rate for19-64%. About the WSI etiologyand pathogenesis there has always been a controversial, its incidence may include avariety of mechanisms, such as blood flow dynamics disorder (Hemodynamicimpairment, HID) theory namely hypoperfusion theory6-8, micro embolus theory1,hypoperfusion and micro embolus (MES) common function theory11, flushing anddamaged theory12. Deficiencies of the cerebral perfusion caused by serious internalcarotid artery or middle cerebral artery stenosis or occlusion and micro embolus getmore and more attention. the internal carotid artery or middle cerebral artery stenosissevere narrowing can cause not only on the same side of the middle cerebral arteryperfusion is low, but also because of narrow part is not stable plaques falls off form thecreate micro embolus embolization. This research use neck ultrasound examination andmagnetic resonance imaging blood vessels (magnetic resonance angiography, MRA),electronic computer X-ray tomography sweep (computedtomography angiography,CTA) inspection method, statistical analysis of patients with cerebral imaging data WSI,this paper discusses the WSI pathogenesis.Methods：To collect139former circulation cerebral infarction with ischemic stroke patients during from January in2010to January in2012at the Department of Neurology of theMiddle Hospital of DaLian， All patients were underwent neck blood vesselsultrasound(CDUS)、magnetic resonance angiography(MRA)、CT angiography(CTA),Above the cases do the electrocardiogram and heart ultrasound examination of the heartand source sex except the atrial fibrillation embolus.Exracranial arterial stenosisaccording to North American symptomatic carotid arery stenosis testingmethod(NASCET) were divied to four groups: level I: totally occluded; Level II: highlynarrow, narrow degree70-99%; III: moderate narrow, narrow degree50%-69%; LevelIV: narrow degree <50%or no abnormalities. Risk factors were recorded such asage,gender, always risk factors, now history and allergic-c-reactive protein results. Andthrough the use of statistical methods to analysis X2inspection collected above inpatients with cerebral infarction of the imaging and clinical data.Results：We found the expected significant relationship between(1) WSI (143cases), no WSI large area cerebral infarction (66cases), lacunarcerebral infarction (69cases), three kinds of cerebral infarction have internal carotidartery (internal carotid artery, ICA) or brain artery (middle cerebral artery, MCA) severenarrowing or the occlusion were59.5%（44/74）、44.8%（13/29）、5.6%（3/36）.(2) CWSI、IWSI、MWSI have ICA or MCA severe stricture, who were44.4%(8/18),66.7%(16/24),43.8%(20/32).(3)The ICA or MCA severe narrowing or block of IWSI is more than CWSI，difference have statistical significance，PWSI (10cases) after the merger circulationhemal stricture rate is high (4cases,40%).Conclusion：(1) The pathogenesis of the most important WSI ICA or MCA in narrow is basedon hemodynamic changes happened， low perfusion to subcortical type on the influenceof the type on cortex WSI.(2) The ICA or MCA severe narrowing or block of IWSI is more than CWSI，PWSI combines ICA or MCA stenosis with circulation of blood vessels and narrow.