1 year Follow-up
Male, 63 years old, TIA
Carotid Stenosis – Endarterectomy
Carotid Stenosis –
Angioplasty and Stent
Male, 73-year-old, TIA
EPI
Male, 63 years old，left extremity weakness for 3 months
Male, 46 years old, periodic dizziness for 3 months.
By-pass operation
STA-MCA Anastomosis
By-pass + carotid stenting
Male, 56 years old, right extremity weakness. High stenosis of right ICA and occlusion of left ICA
Dysphasia Visual field defect
Confusion
VERTEBRAL-BASIC SYSTEM
Homonymous emianopsia Vertigo Diplopia
Facial weakness Ataxia Tinnitus
Stroke
First consultation by cerebrovascular specialists
Ischemic cerebral disease – Clinical presentation
TIA (transient ischemic attack 一过性脑缺血发作)
Infarction（脑梗死）
COMMON SYMPOTOMS
CAROTID SYSTEM
Paraplegia Hemisensory loss Transient monocular blindness
Today’s topics
缺血性脑血管病（Ischemic cerebral vascular diseases）
出血性脑血管病（Hemorrhagic cerebral vascular diseases）
脊柱脊髓血管病（Spine and spinal cord vascular diseases）
Subarachnoid Haemorrhage
• Aneurysmal subarachnoid haemorrhage (SAH) is about 80.3%
----Chinese government: the tenth 5 years project researched result
CT、MRI、SONOGRAPHY、SPECT
Hemorrhagic Ischemic Etiologic diagnosis Etiologic treatment
Protocol
Rehabilitation
“Green Channel Emergency”
Emergency network Acute stroke diagnosed Interventional therapy Surgery Drug therapy
SAH and Aneurysms
subarachnoid hemorrhage
Subaracnoid Hemorrhage – Hunt and Hess Scale
Score Definition
0
Unruptured aneurysm
1
Asymptomatic, or mild HA, and slight nuchal rigidity
Medicine Rehabilitation
Treatment of Ischemic Stroket, anticoagulation, et al)
• Surgical method
– Endarterectomy – STA-MCA by-pass
• Mortality: 25-30% • Morbidity: 60% • The cost to individuals and society in terms
of acute care resources, rehabilitation, chronic care, and lost productivity is enormous.
1a No acute meningeal/brain reaction, but with fixed
neuroological deficit
2
Moderate to severe HA, nuchal rigidity; or CN palsy (i.e.
• Interventional method
– Thrombolysis – Angioplasty (balloon, stent)
Acute Stroke
male，29 years old，right hemiplegia for 1/2 hour，
Thrombolysis
Stenting and follow-up
Hemorrhagic Cerebral Vascular Diseases
• Subarachnoid Hemorrhage and Aneurysms • Cerebral vascular malformations
- arteriovenous malformation - cavernous angioma - venous malformation • Dural arteriovenous fistula • Moyamoya Diseases • Intracerebral hemorrhage
脑与脊髓的血管性疾病
VASCULAR DISEASES in BRAIN and SPINAL CORD
What is it? How to manage it?
流行病学（Epidemiology）
• Annually, 1,500,000 to 2,000,000 Chinese suffer a stroke.