关键词: 颈动脉闭塞; 血液动力学; 脑缺血

Abstract: Objective To investigate the cerebral infarction by computer tomography (CT) and magneticresonance imaging (MRI) ipsilateral to carotid artery occlusion in patients with unilateral carotidartery occlusion and the association between ischemic brain lesions and intracranial collateral bloodflow. To promote our understanding of the pathophysiology of cerebral ischemia.Methods Forty-three patients with unilateral carotid artery occlusion confirmed by coratidultrasound were included. The numbers of infarction were compared in each of five cerebralanatomic regions ipsilateral to the occlusion. The five regions were territory cortical region ofmiddle cerebral artery (MC), anterior watershed cortical region (AWS), posterior watershedcortical region (PWS), internal watershed region (IWS), and perforating artery region (PA). Theassociations between collateral blood flow pattern and infarction in five regions were analyzed.Results The frequency of IWS infarcts in the hemisphere ipsilateral to the occluded carotid arterywas higher (n=17, 44.2%). Six of eight AWS infarcts coexisted with IWS infarcts. The presenceof Posterior communicating artery (PCoA) was a protective factor associated with a reduction inprevalence of IWS infarcts (odd ratio (OR ) =0.226, 95% confidence interval (CI ): 0.058-0.833,P =0.027).Conclusion Higher frequency of IWS infarcts and most of AWS infarcts coexisted with IWSinfarcts suggested a hemodynamic mechanism for stroke with occlusive coratid disease. PCoA wasa protective factor associated with a reduction in prevalence of IWS infarcts.

Key words: Carotid stenosis; Hemodynamics; Brain ischemia