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SIM HO YONG 2008, 03, 15 Masan samsung medical center Cerebrovascular disease of Brain CT.

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Presentation on theme: "SIM HO YONG 2008, 03, 15 Masan samsung medical center Cerebrovascular disease of Brain CT."— Presentation transcript:

1 SIM HO YONG 2008, 03, 15 Masan samsung medical center Cerebrovascular disease of Brain CT

2 CT Angio, Colonography

3 Percentage Percentage of smc Brain CT,2007

4 Percentage of cerebrovascular dz,2007

5  Intracranial vascular anatomy  Basal ganglia anatomy ANATOMY

6 Anterior communicating artery Anterior cerebral artery Ophthalmic artery Internal carotid artery Middle cerebral artery Perforating artery Anterior choroidal artery Superior cerebellar artery Posterior cerebral artery Posterior communicating artery Basilar artery Long and short pontine artery Anterior inferior cerebellar artery Vertebral artery Recurrent artery Lenculostriate artery Hypothalamic artery Perforating artery

7 Basal ganglia Corpus callosum lateral ventricle Interthalamic adhesion Thalamus Putamen Globus pallidus 3 rd ventricle Pineal body Head of caudate nucleus

8 Anterior cerebral A (ACA) Pericallosal A Callosomarginal A Frontopolar A Orbital A

9 Middle cerebral A (MCA)

10 Posterior communicating A Acom. ICA Pcom.

11 PCA

12 AICA SCA PCA Branches of the VBA Posterior cerebral A (PCA) Superior cerebellar A (SCA) Anterior inferior cerebellar A (AICA) Posterio inferior cerebellar A (PICA)

13  Occlusive cerebrovascular diseases  Hemorrhagic cerebrovascular diseases 뇌혈관질환의 병리학적 분류

14  Transient ischemic attack : TIA  Reversible ischemic neurologic deficit : RIND  Progressing stroke  Completed stroke Ischemic cerebrovascular dz

15  50~55ml/100g/min  Ischemic threshold Threshold of electrical failure; 15~18ml/100g/min Threshold of ionic failure; 10~12ml/100g/min Ischemic penumbra; 10~20ml/100g/min Ischemic Cerebrovascular dz Ischemic Cerebrovascular dz

16 Cerebral Infarction(CI)

17 Transient Ischemic Attack(TIA)

18 Transient Ischemic Attack(TIA) ( CI )

19 Cerebral Infarction(CI)

20

21 대표적 뇌혈관질환 별 발생 빈도

22  Cause 1, Hypertension: 70% 2, Aneurysm: 20% 3, AVM: 5.6% 4, Other(CCF, Moyamoya dz, etc): 4.4%  SMC(2007) Brain CT 1, Hypertension: 64.9% 2, Aneurysm: 31.3% 3, AVM: 1.6% 4, Other: 2.2% Intracerebral Hemorrhage(ICH)

23 < Spontaneous Intracerebral Hemorrhage > Aneurysm AVM Moyamoya disease Hemorrhagic brain tumor Hypertensive Intracerebral Hemorrhage Hypertensive Intracerebral Hemorrhage

24  Putaminal hemorrhage : 55%  Thalamic hemorrhage : 10%  Subcortical hemorrhage : 15% = Lobal hemorrhage  Pontine hemorrhage  Cerebellar hemorrhage : 20% Hypertensive Intracerebral Hemorrhage

25 Putaminal hemorrhage

26 Hypertensive Intracerebral Hemorrhage Thalamic hemorrhage

27 Hypertensive Intracerebral Hemorrhage Thalamic hemorrhage

28 Hypertensive Intracerebral Hemorrhage Subcortical hemorrhage = Lobal hemorrhage

29 Hypertensive Intracerebral Hemorrhage Subcortical hemorrhage = Lobal hemorrhage

30 Hypertensive Intracerebral Hemorrhage Pontine hemorrhage

31 Hypertensive Intracerebral Hemorrhage Cerebellar hemorrhage

32 Intracranial Aneurysm

33

34

35

36 Aneurysm at the Lt. anterior cerebral area.

37 Intracranial Aneurysm Aneurysm at the Lt. anterior cerebral area.

38 Intracranial Aneurysm Aneurysm at the middle cerebral bifurcation area.

39 Intracranial Aneurysm P-com area 에 posterior direction 의 aneurysmal sac 이 보이고 size 는 8mm 으로 측정됨. 25%

40 Intracranial Aneurysm P-com area 에 posterior direction 의 aneurysmal sac. – post clipping -

41 Intracranial Aneurysm RT vertebral artery aneurysm

42 Arteriovenous Malformation

43 Carotid Cavernous Fistula(CCF) Enlarged enhancing Rt. cavernous sinus with engorged Rt. superior ophthalmic vein.

44 Moya moya disease

45

46 감사합니다.


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