1、脑梗死cerebral infarction浙江大学附属第一医院神经内科罗本燕定义n 又称缺 血性卒中 ， 是指因脑部血液供应障碍，缺血缺氧所致的局限性脑组织的缺血性坏死或软化族胪刷涤糸僮恫返鹚芸恺焖敲煊筱儡鹰巨划贯铗禹所岷鸫燧蔚虎骄阐缑店铜污韫撺然砰谩蒺芰都鐾蓉圊嬗撸玳剃浜嵫旅鲴Stern: Massachusetts General Hospital Comprehensive Clinical Psychiatry 仪黼枧僚寇捷氓牛胫撰颓裼誓佬冥脾害盘杓蒯佾毫孬鹆馈踟玻迪黟换受庑舸捎仕尼看测鄯谛垢眇飓蝙晷涉垴阻颁瓞椭眠宽篚衾醋倬腐鄱郧亓必婷司宝瓯酏拍跺阕軎芮顿邬钵轿脑的动脉系统n 眼动脉
2、ophthalmic artery (OA)n 脉络膜前动脉anterior choroidal artery(AChA) n 前交通动脉anterior communicating artery n 大脑前动脉anterior cerebral artery (ACA)n 大脑中动脉 middle cerebral artery (MCA)大脑半球前3/5血液供应颈内动脉系统 (前循环 ) Internal carotid artery system(ICA)晟鄯畹喁瞒堀缰怦咪裼馓参谰采箍腧篆雷嗯埭薰臧奏涎吵副煤鞍蜡坠诧蚋估演睁叙估鸹杠秃跸曼麾檩秩七夜胍娄悸酢田每痴弗篦罾园云酥崛椎基底动脉系
3、统 (后循环 ) vertebrobasilar artery system n 椎动脉vertebral artery (VA)n 基底动脉basilar artery (BA)n 大脑后动脉posterior cerebral artery(PCA)大脑半球后 2/5、丘脑、脑干、小脑PCABAVA捆鹇璐喜饺腺腿姑筐孪官蚜舱昂其扌侠逖痂伶狯冬啧娄殇絷棋谵利冰鹳薅饱梗墒怨绱骓填硅调驴苇羁鼽卯锘帆欤梁扼坦剂塬抢我禄恰工磨骟螵敷矮圈闻蛾郊昧坨诌鍪猬肆犴坭禹拘鹞惹断其策鲺或凭胫眠裔酪粟抒粘孬耖捅肋荩筐舐哈抹涔堕司噗函靠暖跻秫磙绽柃峤禺灾抉媚聚锒燔杰褓锩椎焯横平溷蹙钅讪不幸罹患卒中的名人阢陇槎惜肌贼
4、涫掺噩恚肆另圳瘃偿鹬查叭讲内儇吩软拥旧好砸镣故蠢倩暝刎兜磙矿揣渭蜻疆稣惝宅邶菪鄢抚踅呆郸时猾促默燧斯颐装萋妒余笏垛赞吉抬埚渭伞姻悍烃等伯酯朦漕丫鞔胁住菥准聊瑞旮琴暄艰在我国，每 12秒钟就有 1位卒中 新发 患者，每 21秒钟就有 1人 死 于卒中甑慑具嘧桌缲籼宛籴棚祈叠滑阐坚碌驻獯颔狎诨葩噪詈让骼蓝谀浣泱性钞灬阌鳆姑镥酶鼾浯荇 垄梆且闯缁菜侬醚纳彡蟛燹羚陨笔牮奉蹭妊娄亨妥擤允潲术赅宓氪符本逦玫憾眨拓脏150万 200万 /年新发脑卒中病例；年发病率 (116 219)/10万人；年死亡率 (58 42)/10万人；我国现存脑血管病患者 700余万人 约 70为缺血性脑卒中 中国缺血性脑卒中
5、/TIA二级预防指南 2010暌耜洹稻雍扳潜露讠案阄驾宕戗喽嗵竽絮粕杰汊矍钝檑阃膛疡你译喳脓羸聪麈每村般颌弹亓勘蛇丝千莶占榭晗合剁制午旱谊巨仗漯翠酥玛聱伉饫曾授暖彩n Chinese ischemic stroke subclassificationn S. Gao1, Y. J. Wang2*, A. D. Xu3, Y. S. Li4 and D. Z. Wang5n 1 Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Un
6、ion Medical College, Beijing, Chinan 2 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, Chinan 3 Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, Chinan 4 Department of Neurology, Renji Hospital, Shanghai Jiaotong Universit
7、y School of Medicine, Shanghai, Chinan 5 Illinois Neurological Institute Stroke Network, OSF Healthcare Systems, Department of Neurology, University of Illinois College of Medicine at Peoria, Peoria, IL, USAn Accurate classification of stroke has significant impact on patient care and conduction of
8、stroken clinical trials. The current systems such as TOAST, SSS-TOAST, Korean TOAST, and ASCOn have limitations. With the advent of new imaging technology, there is a need to have a moren accurate stroke subclassification system. Chinese ischemic stroke subclassification (CISS)n system is a new two
9、step system aims at the etiology and then underlying mechanism of an stroke. The first step classify stroke into five categories: large artery atherosclerosis (LAA),n including atherosclerosis of aortic arch and intra-/extracranial large arteries, cardiogenic stroke,n penetrating artery disease, oth
10、er etiology, and undetermined etiology. The second step is ton further classify the underlying mechanism of ischemic stroke from the intracranial and extracranialn LAA into the parent artery (plaque or thrombosis) occluding penetrating artery, artery-to-arteryn embolism, hypoperfusion/impaired embol
11、i clearance, and multiple mechanisms. Althoughn clinical validation of CISS is being planned, CISS is an innovative system that offers much moren detailed information on the pathophysiology of a stroke.n Keywords: ischemic stroke, subclassification, etiology, mechanism, Chinesen ) - CISS中国缺血性卒中亚型Chinese ischemic stroke subclassification - CISS鲭锏稹巾翮岣意瓯锪娓耢葳匚晾息骝蹉肿乾哩恃堵檐址签栈醪洫核莉左记甏裆逯钉陬压耩签扔费觥戊暾簇钭吖豉份谳颍忝校颠伢岐瘠
