神经病学课件：Cerebrovascular Diseases.pptVIP

Cerebrovascular Diseases OutlineIntroductionTransient Ischemic Attacks (TIA)Ischemic strokeIntracerebral HemorrhageSubarachnoid Hemorrhage IntroductionDefinitionA group of brain dysfunctions related to disease of the blood vessels supplying the brainStroke: cerebrovascular accidentSudden loss of blood circulation to an area of the brain, with corresponding loss of neurologic function.As if “struck by the hand of God” EpidemiologyThird leading cause of death Approximately 2 million new strokes each year in chinaAssociated with risk factors (see below) Blood supply of the BrainInternal carotid arteryVertebral-basilar arteryThey are interconnected by an arterial circle (of Willis) INTERNAL CAROTID ARTERY INTERNAL CAROTID ARTERYEnters cranium via the carotid canal of the temporal boneSupplies dura, hypophysis, tympanic cavity and trigeminal gangliaProvide direct branches to the optic nerve, optic chiasm, hypothalamus and genu of internal capsulTerminal branches are the anterior and middle cerebral arteries Anterior cerebral artery (ACA) Anterior cerebral arteryCortical branches supply all the medial surface of the cerebral cortex (basal ganglia, corpus callosum) as far back as the parieto-occipital sulcus.Key functional areasPrimary motor cortex for leg and footMotor planning in medial frontal lobeMiddle and anterior corpus callosum? Middle cerebral artery Middle cerebral artery (MCA)Largest branch, Runs in the lateral sulcusDivides into superior and inferior branchSuperior MCA – lateral and inferior frontal, anterior part of parietal Inferior MCA – lateral temporal, posterior parietal, lateral occipital.Central perforating branches supply the lentiform and the caudate nuclei and the internal capsule Deep branches of MCA Key functional areas of MCAPrimary motor cortex for face, arm, legPrimary sensory cortex for face, arm, legBroca’s language area (motor aphasia)Wernicke’s area (sensory aphasia)Perception of own body, outside world and ability to express emotions A