lenticulostriate occlusion
Introduction
Introduction The central branch of the middle cerebral artery is called the lateral bean vein artery, which can be divided into two groups: the inner and the outer artery. They wear a fabric that is worn in front of the lenticular nucleus, the caudate nucleus and the inner sac of the body for 2/3 of the forelimbs and hind limbs. Most of the blood vessels in the brain occur in the bean vein arteries. Therefore, some people call the bean vein artery a "bleeding artery." The bean-like artery is a small blood vessel that dominates the basal ganglia in the middle of the cerebral artery. In fluid mechanics, this vertical structure is subjected to greater pressure, which makes the bean vein the most common bleeding. Blood vessels, bean-like arteries are also called bleeding arteries.
Cause
Cause
Bean occlusion is often caused by blood vessel bleeding in the brain.
The bean-like artery is a small blood vessel that dominates the basal ganglia in the middle of the cerebral artery. In fluid mechanics, this vertical structure is subjected to greater pressure, which makes the bean vein the most common bleeding. Blood vessels, bean-like arteries are also called bleeding arteries.
Vertically emitted blood vessels, from a fluid mechanics point of view, blood turbulence occurs when flowing through this branch, increasing the impact on the vessel wall. In the case where the vascular endothelial cells have been damaged, it is more likely to cause damage, resulting in an increase in the gap of the endothelial cells, and blood substances (lipids, calcium, etc.) ooze out to the deep layers of the endothelial cells of the blood vessel wall and deposit (atherosclerosis).
Examine
an examination
Related inspection
Brain CT examination of brain MRI Doppler echocardiography
1. Brain CT scan: The main manifestations of brain CT scan of cerebral infarction are:
1 The low density of the lesion: it is an important characteristic manifestation of cerebral infarction, which may be caused by ischemic edema of the brain tissue.
2 local brain tissue swelling: manifested as the disappearance of the sulci, the cerebral cistern and ventricle were compressed and deformed, and the midline structure was shifted to the contralateral side, that is, the brain CT scan showed a mass effect. This sign can be observed 4 to 6 hours after the onset of the disease.
3 dense arterial shadow: for the increase of the density of the main cerebral artery, common in the middle cerebral artery. The mechanism is due to the fact that the thrombus or embolus is more dense than the contralateral or surrounding brain tissue. Some patients may appear within 24 hours of ischemia.
2. Brain MRI examination: It can detect cerebral infarction earlier, especially the brain stem and cerebellum. The relaxation time of T1 and T2 was prolonged. On the weighted image, T1 showed a low signal in the lesion area, T2 showed a high signal, and brain MRI examination could find a small infarct lesion. Brain MRI diffusion imaging can reflect the new infarct lesion. MRI has shown advantages in the early diagnosis and differential diagnosis of ischemic cerebral infarction. In recent years, superconducting high-grade magnetic resonance equipment has been put into clinical application, magnetic resonance diffusion weighted imaging (DWI) based on plane echo (EPI) technology and The application of perfusion-weighted imaging (PWI) has made some progress in the early diagnosis of cerebral infarction, and even in the study of blood perfusion changes and pathophysiological processes in acute cerebral infarction.
3. DSA, MRA, transcranial Doppler ultrasonography: The main purpose of these three tests is to find the cause of blood vessels in cerebrovascular disease. Transcranial Doppler ultrasonography is cheap and convenient, and can detect abnormalities of large blood vessels (such as anterior cerebral artery, middle cerebral artery, posterior cerebral artery and basilar artery). Brain MRA examination is simple and convenient, can exclude vascular lesions of larger arteries, and help to understand the location and extent of vascular occlusion. DSA can detect smaller vascular lesions and can be used in a timely manner.
Diagnosis
Differential diagnosis
Differential diagnosis of Bean Artery Occlusion:
1. The central artery of the middle cerebral artery: also called the bean vein artery or the anterior lateral central artery, which is divided into the medial branch and the lateral branch. The medial branch, within 1cm of the origin of the middle cerebral artery, is usually issued at a right angle, about 2 to 3 branches, short and thin. After being emitted from the trunk, it is arranged in a comb-like parallel direction and penetrates into the anterior medial part. Pass through the inner capsule to the caudate nucleus. In neonates, this artery is mostly 4-6, accounting for 63.3%. The lateral branch, issued from the beginning of the middle cerebral artery 1cm, about 4-6, long and thick, if it is issued as a branch, it is also divided into 3 to 5 penetrating into the brain parenchyma, neatly along the lateral olfactory cleft Arranged at the end, fan-shaped through the shallow layer of the lenticular nucleus or curved upward through the inner capsule to the caudate nucleus.
2, the internal carotid artery and the choroidal artery: the internal carotid artery directly penetrates into the brain parenchyma, mainly the choroidal artery. Sometimes the anterior perforating artery and the striate cystic artery are directly emitted.
1 choroidal anterior artery, 1 to 4, with the largest of 3, a group of small and constant blood vessels, directly from the internal carotid artery 2 mm distal to the posterior communicating artery. Before the artery enters the lower ventricle of the lateral ventricle, in addition to 1 to 3 cortical branches, it also emits 2 to 3 perforating branches, 1 through the medial side of the optic nerve to the cerebral peduncle, and the other two are the striate cystic artery. This artery is mainly a nutrient caudate nucleus, with a long stroke and a small diameter, which is prone to embolism.
2 striate cystic artery, 97% from the choroidal artery, with more than 2, one through the beam obliquely to the rear of the globus. The other branch is posterior to the saccular space in the posterior aspect of the optic tract, and the posterior limb of the sac and the nucleus of the lenticular nucleus follows the visual radiation and branches to the globus pallidus.
3. The central artery of the posterior cerebral artery:
1 posterior choroidal artery, mostly one, accounting for 81%. The artery is constantly flattened from the lateral aspect of the posterior cerebral artery to the lateral segment of the posterior cerebral artery, and goes outward into the hippocampus to the lower part of the lateral ventricle to form a choroid plexus, which is branched from the plexus to the caudate nucleus.
2 Thalamic geniculate arteries, mainly from the posterior cerebral artery, were most common in 3 to 4 branches, accounting for 66%, and their distal branches were distributed to the lenticular nucleus.
4, nodular thalamic artery: from the posterior side of the posterior communicating artery at a right angle, in front of the junction of the cerebral ventricle and the nipple, enter the brain parenchyma, through the ventral ventral side of the thalamus, the first level branch is issued at an acute angle, upwards and inwards To the caudate nucleus.
