| Objective: to study relation between creation and compensation of collateral circulation and patient`s clinical symptom during period of cerebral artery occlusion and severe stenosis through DSA examination, find out major pattern of collateral circulation and provide reliable evidence for selection of therapy,judgement of prognosi and effective prevention. Method: to analyze retrospectively 14 patients suffering ischemic cerebrovascular disease who were hospitalized in neurological department of the second affiliated hospital of Dalian Medical University during period from April,2002 to March,2005, DSA and brain CT were performed in all patients, some of whom were checked with MRI(MRA). To discuss possible pattern of compensation of collateral circulation and the relation between the former and clinical symptom and sign, analyze the effect of collateral circulation on earlier diagnosis,treatment and prognosi of patient with ischemic cerebravascular disease according to diagnostic standard of artery stenosis,collateral blood stream and grade of perfusion of cerebral blood flow Result: 14 cases in this group, 8 males, 6 females, aged from 15 to 75 years, average age was 57.1 years. There were 11 cases in symptom group including 3 cases of TIA, one episodic barylalia, one repeated tic, one right drooping eyelid, one vertigo, one dizziness, 3 cases of persistent paralysis in unilateral limb. There were 3 cases in symptomless group. Etiological factor or basal disease include hypertension,hyperlipemia,coronary heart disease,atrial fibrillation diabetes mellitus,stroke family history,high blood adhesion and smoking and son. One case was Moyamoya disease. One case was subarachnoid hemorrhage, complete occlusion at onset of unilateral internal carotid artery without corresponding clinical symptom was found through DSA in one case. MRA and DSA were performed in one case because of swell feeling at scalp with result that main stem of unilateral middle cerebral artery completely occluded(specific time is unclear) but lacking corresponding clinical symptom too. Through DSA it was found that there were 7 cases of unilateral internal carotid artery occlusion, one bilateral vertebral artery occlusion, 2 cases of unilateral vertebral artery occlusion, 2 cases of unilateral middle cerebral artery occlusion, one basilar artery occlusion, one unilateral subclavian artery occlusion. It was found through that when occlusion or severe stenosis occurred at unilateral cerebral vessel compensation could take place through creating quick and effective collateral circulation and anastomosing from multiple way, therefore, neurologic impairment could be avoided or relieved. Vessels that participated anastomosis and supplying blood mainly include anterior and posterior communicating artery,branch of external carotid artery,ophthalmic artery,ascending cervical artery,deep cervical artery,vertebral artery,posterior inferior cerebellar artery,superior cerebellar artery,anterior spinal artery and so on. Under individual circumstance blood could be supplied through unclosed primitive trigeminal artery and primitive sublingual artery. Author summed up possible collateral circulation patter during period of main cerebral vessel occlusion including unilateral common carotid artery,internal carotid artery(before ophthalmic artery),stem of middle cerebral artery,middle piece of basilar artery,proximal subclavian artery and so on. It was also found that unilateral vessel occlusions in 3 patients without apparentclinical symptom were found either through DSA examination because of other diseases or through MRA and further DSA examination because of slight symptom such as swelling head and the collateral circulation was nice, thus it was supposed that unilateral vessel occlusion and creation of collateral circulation is a gradual process, as showed that whether there is clinical symptom or not and the degree depend on whether collateral circulation is sufficient and the latter has some thing to do with speed of vessel occlusion. eithe...
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