1、Internal carotid artery occlusionand Evaluation of collateral circulation 1 CASE ONE：Male,40 years old,hospitalized wiith speech difficulties and one-side limbs weakness for 4 hours,4 years Headache history,physical examinations:muscle strength grades(MSG)is III.NIHSS score is 6.MRI（see chart below）
2、，），abnormal blood lipid level。2 Question：Reason of small infarct size？Reason of occlusion？How to deal？345Reason:Collateral circulation No atherosclerosis plaque.Headache historyConclusion:Artery Dissection6Artery Dissection7Treatment:High-operative-risk Well-developed collateral circulation Conclusi
3、on：non-operative treatments 8Importantance of collateral circulationDiagnosis.Treatment.Prognosis and risk.9No collateral circulation:10Internal carotid artery occlusion 1：Chronic occlusion2：Acute occlusion 1）Collateral circulation 2）No collateral compensation Severe clinical symptoms?=11Review：12Wh
4、ich？Wills Arterial network of the pia mater（皮层软膜（皮层软膜代偿）代偿）Others（肌支及（肌支及ECA）13Wills：1：Posterior communicating artery（PCoA）2：Anterior communicating artery（ACoA）3：A1 segment of anterior cerebral artery（A1）4：P1 segment of posterior cerebral artery（P1）5：supraclinoid segment of the internal carotid arte
5、ry14 DSA：Wills15Arterial network of the pia mater：前交通动脉代前交通动脉代/额顶叶来源于患侧大额顶叶来源于患侧大脑前动脉软膜吻合脑前动脉软膜吻合，16Others:1 1：Facial arteryFacial artery（面动脉）（面动脉）2 2：Superficial temporal arterySuperficial temporal artery （颞浅动脉）（颞浅动脉）3 3：Middle meningeal arteryMiddle meningeal artery （脑膜中动脉）（脑膜中动脉）4 4：Posterior com
6、municating artery （后交通动脉）（后交通动脉）5 5：Foramen artery Foramen artery（圆孔动脉）（圆孔动脉）6 6：Ascending pharyngeal artery Ascending pharyngeal artery （咽升动脉）（咽升动脉）7 7：Occipital artery Occipital artery（枕动脉）（枕动脉）8：Ascending carotid artery （颈升动脉）（颈升动脉）10：Superior thyroid artery Inferior thyroid artery （甲状腺上下动脉）（甲状腺上下动脉）17DSA：18Circulation：19Collateral circulation：Encircling the cities from rural areas Supplying the government from border areas.20THANK YOU21
