关键词: 动脉瘤; 夹层; 脑梗死; 发病机制

Abstract: Objective This study investigated the mechanism of ischemic stroke induced by cerebral arteriesdissection through brain imaging and cerebrovascular findings, and provided evidences for therelative strategies of therapy.Methods Twenty-eight patients with acute ischemic infarct induced by cerebral arteries dissectionconfirmed by clinical and neuroradiological data were recruited. Mechanisms of ischemic infarctwere determined by the infarct lesion morphous and distribution. All patients were divided intothe extracranial group and the intracranial group according to the location of vessel lesions, andthe mechanisms of the two groups were compared.Results Twenty-eight patients (19 males and 9 females) were recruited. There were 17 patientswith extracranial dissection, 15 patients with extracranial internal carotid artery dissection and 2patients with V1 segment dissection of vertebral artery. There were 11 patients with intracranialdissection, 3 patients with M1 segment dissection of middle cerebral artery and 6 patients withV4 segment dissection of vertebral artery and 2 patients with basilar artery dissection. There were7 patients (63.6%) with hypertension and 5 patients (45.5%) with diabetes in the intracranial group,and one patient (5.9%) and one patient (5.9%) respectively in the extracranial group (P valueswere 0.002 and 0.022). There were 12 patients (70.6%) with only thromboembolism infarction inthe extracranial group, 2 patients (18.2%) in the intracranial group (P =0.020). In the intracranialgroup, there were 7 patients (63.6%) with infarction resulted in obstruction of perforatingbranches caused by dissection lesion, and one patient (9.1%) with infarction caused by obstruction of perforating branches and hemodynamic mechanism.Conclusion The mechanisms of ischemic infarct induced by extracranial and intracranialdissection were different. Thromboembolism was the main mechanism of infarct induced byextracranial dissection, and obstruction of perforating branches caused by dissection lesion wasthe main mechanism of infarct induced by intracranial dissection.

Key words: Aneurysm; dissecting; Brain infarction; Pathogenesy