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Stroke:MCA卒中同侧丘脑神经机能联系不能

2018-05-23 杨中华 脑血管病及重症文献导读

丘脑的血供主要来自于大脑后动脉的穿通动脉,大脑中动脉闭塞不会影响到丘脑供血。但是有报告显示在MCA卒中的亚急性期和慢性期,在椎基底动脉正常的情况下丘脑的代谢和灌注会下降。

丘脑的血供主要来自于大脑后动脉的穿通动脉,大脑中动脉闭塞不会影响到丘脑供血。但是有报告显示在MCA卒中的亚急性期和慢性期,在椎基底动脉正常的情况下丘脑的代谢和灌注会下降。

这种独特的现象可能就是一种神经机能联系不能现象(Diaschisis phenomenon)。神经机能联系不能是指脑损害的远隔部位的脑区域发生功能、代谢和灌注下降。1914年von Monakow首次使用了这个词汇,1981年Baron JC首次采用PET影像在幕上卒中患者中观察到神经机能联系不能,发现对侧小脑低代谢(也称交叉性小脑神经功能联系不能)。在接下来的几年中,人们也发现了类似现象,比如丘脑皮质、跨半球、同侧丘脑神经机能联系不能(ipsilateral thalamic diaschisis,ITD)。

在MCA卒中的亚急性期和慢性期,不同研究报道ITD的发生率从43%到86%。目前尚缺乏ITD的纵向研究,因此不清楚ITD的时间变化过程。鉴于交叉性小脑神经功能联系不能的时间过程,推测卒中后ITD也会逆转。另外,也不清楚ITD是否对长期神经功能预后产生影响。在卒中慢性期的研究中,有人发现无论是否存在ITD,患者的临床预后类似,但是也有人发现同侧丘脑低代谢会降低患者的运动功能。

2018年4月来自德国的Paul Reidler等在Stroke上发表了他们的研究结果,他们通过灌注CT评价例急性MCA卒中患者ITD的灌注和临床作用特征。

举例:图A(ITD-患者),79岁,男性,急性右侧ICA闭塞。CBF和MTT未见丘脑低灌注,DWI未见丘脑梗死:



举例:图B(ITD+患者),73岁,女性,急性右侧ICA和M1闭塞。CBF和MTT可见丘脑低灌注,DWI未见丘脑梗死:



该研究从一项1644例患者的前瞻性队列中筛选了124例进行了多参数CT包括CTA的MCA卒中患者。ITD定义为>=2灌注图(perfusion maps)中发现同侧丘脑低灌注。

他们发现ITD的发生率为25/124(20.2%,ITD+)。与ITD-患者相比,ITD+患者尾状核、内囊和豆状核的灌注更容易受累及(P皆<0.001)。在ITD+患者组,CBF和CBV不足的体积(deficit volumes)更大,并且CBF-CBV错配较小(P = 0.021)。在治疗亚组中,ITD与最终的梗死体积或出院时临床预后无独立相关性(P皆>0.05)。ITD对卒中亚急性期的并发症没有影响。

最终作者认为对于明显累及皮层下区域的MCA急性期卒中,丘脑低灌注很常见。ITD不会引起丘脑梗死,对患者的预后没有影响。自动化软件不应把ITD错误地分类为缺血核心。

译者注:理论上讲单纯MCA闭塞不会影响患者的意识水平,但是临床上的确能见到单纯MCA闭塞(无脑室受压和中线移位)患者合并意识障碍。什么原因,与ITD有关?

原始出处:
Paul Reidler, Kolja M. Thierfelder, Matthias P. Fabritius, et al. Thalamic Diaschisis in Acute Ischemic Stroke: Occurrence, Perfusion Characteristics, and Impact on Outcome. Stroke. Mar 2018. 

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1709612, encodeId=3e151e09612ed, content=<a href='/topic/show?id=a919849e3ff' target=_blank style='color:#2F92EE;'>#脑神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84973, encryptionId=a919849e3ff, topicName=脑神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b8031759349, createdName=siiner, createdTime=Sun Apr 14 15:41:00 CST 2019, time=2019-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1558300, encodeId=f8af1558300fc, content=<a href='/topic/show?id=c8a7208e8a8' target=_blank style='color:#2F92EE;'>#丘脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20878, encryptionId=c8a7208e8a8, topicName=丘脑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb8814960000, createdName=xlwang2696, createdTime=Fri May 25 11:41:00 CST 2018, time=2018-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564309, encodeId=3a2815643096e, content=<a href='/topic/show?id=c8a7208e8a8' target=_blank style='color:#2F92EE;'>#丘脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20878, encryptionId=c8a7208e8a8, topicName=丘脑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb8814960000, createdName=xlwang2696, createdTime=Fri May 25 11:41:00 CST 2018, time=2018-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=318161, encodeId=ce173181615b, content=远端缺血效益吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Thu May 24 15:29:46 CST 2018, time=2018-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026056, encodeId=767210260562e, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed May 23 23:41:00 CST 2018, time=2018-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317930, encodeId=d4e231e9306c, content=丘脑的血供主要来自于大脑后动脉的穿通动脉.大脑中动脉闭塞不会影响到丘脑供血.但是有报告显示在MCA卒中的亚急性期和慢性期.在椎基底动脉正常的情况下丘脑的代谢和灌注会下降., beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Wed May 23 22:37:46 CST 2018, time=2018-05-23, status=1, ipAttribution=)]
    2019-04-14 siiner
  2. [GetPortalCommentsPageByObjectIdResponse(id=1709612, encodeId=3e151e09612ed, content=<a href='/topic/show?id=a919849e3ff' target=_blank style='color:#2F92EE;'>#脑神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84973, encryptionId=a919849e3ff, topicName=脑神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b8031759349, createdName=siiner, createdTime=Sun Apr 14 15:41:00 CST 2019, time=2019-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1558300, encodeId=f8af1558300fc, content=<a href='/topic/show?id=c8a7208e8a8' target=_blank style='color:#2F92EE;'>#丘脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20878, encryptionId=c8a7208e8a8, topicName=丘脑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb8814960000, createdName=xlwang2696, createdTime=Fri May 25 11:41:00 CST 2018, time=2018-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564309, encodeId=3a2815643096e, content=<a href='/topic/show?id=c8a7208e8a8' target=_blank style='color:#2F92EE;'>#丘脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20878, encryptionId=c8a7208e8a8, topicName=丘脑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb8814960000, createdName=xlwang2696, createdTime=Fri May 25 11:41:00 CST 2018, time=2018-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=318161, encodeId=ce173181615b, content=远端缺血效益吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Thu May 24 15:29:46 CST 2018, time=2018-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026056, encodeId=767210260562e, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed May 23 23:41:00 CST 2018, time=2018-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317930, encodeId=d4e231e9306c, content=丘脑的血供主要来自于大脑后动脉的穿通动脉.大脑中动脉闭塞不会影响到丘脑供血.但是有报告显示在MCA卒中的亚急性期和慢性期.在椎基底动脉正常的情况下丘脑的代谢和灌注会下降., beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Wed May 23 22:37:46 CST 2018, time=2018-05-23, status=1, ipAttribution=)]
    2018-05-25 xlwang2696
  3. [GetPortalCommentsPageByObjectIdResponse(id=1709612, encodeId=3e151e09612ed, content=<a href='/topic/show?id=a919849e3ff' target=_blank style='color:#2F92EE;'>#脑神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84973, encryptionId=a919849e3ff, topicName=脑神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b8031759349, createdName=siiner, createdTime=Sun Apr 14 15:41:00 CST 2019, time=2019-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1558300, encodeId=f8af1558300fc, content=<a href='/topic/show?id=c8a7208e8a8' target=_blank style='color:#2F92EE;'>#丘脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20878, encryptionId=c8a7208e8a8, topicName=丘脑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb8814960000, createdName=xlwang2696, createdTime=Fri May 25 11:41:00 CST 2018, time=2018-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564309, encodeId=3a2815643096e, content=<a href='/topic/show?id=c8a7208e8a8' target=_blank style='color:#2F92EE;'>#丘脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20878, encryptionId=c8a7208e8a8, topicName=丘脑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb8814960000, createdName=xlwang2696, createdTime=Fri May 25 11:41:00 CST 2018, time=2018-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=318161, encodeId=ce173181615b, content=远端缺血效益吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Thu May 24 15:29:46 CST 2018, time=2018-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026056, encodeId=767210260562e, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed May 23 23:41:00 CST 2018, time=2018-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317930, encodeId=d4e231e9306c, content=丘脑的血供主要来自于大脑后动脉的穿通动脉.大脑中动脉闭塞不会影响到丘脑供血.但是有报告显示在MCA卒中的亚急性期和慢性期.在椎基底动脉正常的情况下丘脑的代谢和灌注会下降., beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Wed May 23 22:37:46 CST 2018, time=2018-05-23, status=1, ipAttribution=)]
    2018-05-25 xlwang2696
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    2018-05-24 baihao215

    远端缺血效益吗?

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1709612, encodeId=3e151e09612ed, content=<a href='/topic/show?id=a919849e3ff' target=_blank style='color:#2F92EE;'>#脑神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84973, encryptionId=a919849e3ff, topicName=脑神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b8031759349, createdName=siiner, createdTime=Sun Apr 14 15:41:00 CST 2019, time=2019-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1558300, encodeId=f8af1558300fc, content=<a href='/topic/show?id=c8a7208e8a8' target=_blank style='color:#2F92EE;'>#丘脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20878, encryptionId=c8a7208e8a8, topicName=丘脑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb8814960000, createdName=xlwang2696, createdTime=Fri May 25 11:41:00 CST 2018, time=2018-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564309, encodeId=3a2815643096e, content=<a href='/topic/show?id=c8a7208e8a8' target=_blank style='color:#2F92EE;'>#丘脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20878, encryptionId=c8a7208e8a8, topicName=丘脑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb8814960000, createdName=xlwang2696, createdTime=Fri May 25 11:41:00 CST 2018, time=2018-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=318161, encodeId=ce173181615b, content=远端缺血效益吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Thu May 24 15:29:46 CST 2018, time=2018-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026056, encodeId=767210260562e, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed May 23 23:41:00 CST 2018, time=2018-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317930, encodeId=d4e231e9306c, content=丘脑的血供主要来自于大脑后动脉的穿通动脉.大脑中动脉闭塞不会影响到丘脑供血.但是有报告显示在MCA卒中的亚急性期和慢性期.在椎基底动脉正常的情况下丘脑的代谢和灌注会下降., beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Wed May 23 22:37:46 CST 2018, time=2018-05-23, status=1, ipAttribution=)]
    2018-05-23 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1709612, encodeId=3e151e09612ed, content=<a href='/topic/show?id=a919849e3ff' target=_blank style='color:#2F92EE;'>#脑神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84973, encryptionId=a919849e3ff, topicName=脑神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b8031759349, createdName=siiner, createdTime=Sun Apr 14 15:41:00 CST 2019, time=2019-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1558300, encodeId=f8af1558300fc, content=<a href='/topic/show?id=c8a7208e8a8' target=_blank style='color:#2F92EE;'>#丘脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20878, encryptionId=c8a7208e8a8, topicName=丘脑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb8814960000, createdName=xlwang2696, createdTime=Fri May 25 11:41:00 CST 2018, time=2018-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564309, encodeId=3a2815643096e, content=<a href='/topic/show?id=c8a7208e8a8' target=_blank style='color:#2F92EE;'>#丘脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20878, encryptionId=c8a7208e8a8, topicName=丘脑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb8814960000, createdName=xlwang2696, createdTime=Fri May 25 11:41:00 CST 2018, time=2018-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=318161, encodeId=ce173181615b, content=远端缺血效益吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Thu May 24 15:29:46 CST 2018, time=2018-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026056, encodeId=767210260562e, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed May 23 23:41:00 CST 2018, time=2018-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317930, encodeId=d4e231e9306c, content=丘脑的血供主要来自于大脑后动脉的穿通动脉.大脑中动脉闭塞不会影响到丘脑供血.但是有报告显示在MCA卒中的亚急性期和慢性期.在椎基底动脉正常的情况下丘脑的代谢和灌注会下降., beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Wed May 23 22:37:46 CST 2018, time=2018-05-23, status=1, ipAttribution=)]
    2018-05-23 有备才能无患

    丘脑的血供主要来自于大脑后动脉的穿通动脉.大脑中动脉闭塞不会影响到丘脑供血.但是有报告显示在MCA卒中的亚急性期和慢性期.在椎基底动脉正常的情况下丘脑的代谢和灌注会下降.

    0

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