脑血管狭窄与分水岭脑梗死的研究进展

分水岭脑梗死(CWI)又称为边缘带脑梗死、交界区脑梗死等,是一种特殊类型的脑梗死。其病因和发病机制复杂,其中血管狭窄性病变作为CWI重要的发病机制之一而受到广泛关注。国内外学者研究报道指出,在不同类型的CWI患者中,通过行颈部血管彩超、经颅多普勒超声、磁共振灌注成像等血管检查技术,均能够发现大脑中动脉或颈内动脉等颅内大血管的狭窄性病变。此外,动脉粥样硬化斑块的稳定性亦作为重要的危险因素参与CWI的形成。由于可以针对不同病因采取相应治疗措施,因此CWI的预后情况通常较好。对于那些不稳定斑块或血管狭窄病变的CWI患者,及早进行血管内治疗,必要时行血管内膜剥脱术或支架植入术,可有效降低缺血性卒中的再发风险,对改善CWI的预后具有重要的临床价值。

Research Progress of Cerebral Vascular Stenosis and Watershed Infarction

Cerebral watershed infarction（CWI） ,also known as marginal zone infarction,junctional zone infarction,is a special type of cerebral infarction. The causes and pathogenesis are complicated, and vascular stenosis lesions, as one of the important pathogenesis of cerebral infarction has attracted widespread attention. Scholars reported that in different types of CWI patients, we can find the stenosis and other intracranial vascu- lar lesions in middle cerebral artery or internal carotid arterythreugh the vascular examination technology, such as CDS ,TCD and MRA,etc, In addition,atheresclerotic plaque stability is also an important risk factor involved in the formation of CWI Prognosis is relatively good for watershed infarction, if we take different treatment measures for different causes. For the existence of vascular stenosis or unstable atherosclerotic plaque in CWI patients, early intravascular treatment should be taken, if necessary, vascular endarterectomy or stent implantation should be done, in order to effectively reduce the recurrence of ischemic stroke risk, which has important clinical value to improve the prognosis of CW.I.