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后循环卒中
$68.39
后循环卒中虽较前循环少见,但脑干的解剖功能复杂性造成诊断困难、疗效欠佳;而相应的研究较少,急性治疗方案和预防策略仍有争议。这是原著作者编写此书的初心。 本书包括全面和的后循环卒中知识,涵盖血管解剖、病理学、流行病学、发病机制,到临床表现、诊断方式和治疗策略等方面;旨在为临床和科研工作提供参考。所有章节均由国际知名专家和科学家撰写,翻译团队也几经校对,尽可能准确地体现了原著的科学水平。 本书适合神经...
后循环卒中虽较前循环少见,但脑干的解剖功能复杂性造成诊断困难、疗效欠佳;而相应的研究较少,急性治疗方案和预防策略仍有争议。这是原著作者编写此书的初心。 本书包括全面和的后循环卒中知识,涵盖血管解剖、病理学、流行病学、发病机制,到临床表现、诊断方式和治疗策略等方面;旨在为临床和科研工作提供参考。所有章节均由国际知名专家和科学家撰写,翻译团队也几经校对,尽可能准确地体现了原著的科学水平。 本书适合神经外科、神经内科、急诊科以及影像科的医师和相关专业的医学生学习参考。
目 录
章 椎基底动脉系统卒中和短暂性脑缺血发作的历史节 早期解剖学和临床病理学研究第二节 后循环缺血第三节 早期临床研究第四节 20世纪下半叶的临床病理学和临床影像学研究第五节 后循环缺血患者的治疗第六节 椎基底动脉区域脑出血第二章 动脉解剖与侧支循环节 胚胎学第二节 解剖学一、椎动脉二、基底动脉三、大脑后动脉第三节 侧支循环第三章 流行病学、危险因素和卒中机制节 后循环卒中的患病率第二节 危险因素一、一般危险因素二、后循环与前循环卒中危险因素的差异第三节 卒中机制一、大动脉病变二、小动脉(穿支血管)病变三、心源性栓塞四、前循环卒中和后循环卒中机制的差异五、少见病因第四章 脑干梗死综合征节 延髓梗死一、延髓外侧部梗死二、延髓内侧部梗死第二节 脑桥梗死一、临床表现二、临床-解剖部位相关性三、卒中机制四、预后第三节 中脑梗死一、临床表现二、临床-解剖部位相关三、卒中机制四、预后第四节 基底动脉尖综合征一、临床表现二、卒中机制和预后第五章 丘脑和其他类型大脑后动脉卒中综合征引言节 大脑后循环的解剖一、丘脑的血液供应二、后循环卒中的皮质分支第二节 丘脑卒中综合征一、丘脑前部梗死二、旁正中丘脑梗死三、下外侧丘脑梗死四、丘脑后部梗死五、变异: 丘脑前正中梗死六、变异: 中央丘脑梗死七、变异: 丘脑后外侧梗死八、变异: 双侧丘脑旁正中梗死第三节 非丘脑后循环卒中综合征一、不累及丘脑的后循环卒中的临床特征二、根据闭塞部位分组的后循环卒中综合征第四节 后循环卒中的预后第六章 小脑梗死引言/流行病学节 分类一、小脑后下动脉梗死二、小脑前下动脉梗死三、小脑上动脉梗死四、多发性梗死五、小脑小梗死六、腔隙性脑梗死第二节 小脑梗死的病因第三节 治疗第四节 预后第七章 眼、前庭和耳综合征引言节 延髓卒中一、延髓外侧部梗死二、延髓内侧部梗死第二节 脑桥卒中一、眼球震颤和扫视性侵扰/扫视性振荡二、核间性眼肌麻痹三、水平凝视麻痹四、一个半综合征五、外展麻痹六、其他发现第三节 中脑卒中一、基底动脉尖部的眼球功能障碍二、动眼神经神经麻痹三、滑车神经麻痹四、核间性眼肌麻痹第四节 小脑卒中一、小脑前下动脉梗死二、小脑后下动脉梗死三、小脑上动脉梗死第八章 出血性卒中节 流行病学第二节 病因学与病理生理学一、原发性脑出血二、继发性脑出血第三节 诊断第四节 临床特征一、丘脑出血二、中脑出血三、脑桥出血四、延髓出血五、小脑出血六、皮质出血第五节 治疗一、血压控制二、与抗栓治疗相关的ICH三、颅内压增高的控制四、脑出血的外科治疗第六节 预后第九章 影像诊断引言节 脑组织影像一、计算机断层扫描二、磁共振成像第二节 脑血管成像一、CT血管成像二、磁共振血管成像三、血管壁MRI四、数字减影血管造影五、超声第三节 灌注成像一、CT灌注成像二、磁共振灌注第十章 药物治疗引言节 急性卒中的重症管理第二节 抗血小板治疗第三节 抗凝治疗第四节 危险因素管理一、血压管理二、血脂管理三、其他危险因素控制第十一章 溶栓与取栓术概要背景节 临床症状和血栓位置第二节 溶栓治疗一、历史背景二、动脉内溶栓第三节 机械(非药物)血管内治疗一、血管内治疗的发展演变二、脑缺血机械栓子清除术装置三、Penumbra抽吸系统四、支架类取栓装置五、血管内治疗的早期证据六、现代血管内试验七、血管内治疗的选择标准八、技术考虑第四节 未来方向第十二章 血管成形术和支架植入术治疗后循环卒中引言节 随机临床试验第二节 随机试验的结果告诉了我们什么?第三节 当前的数据应该如何影响临床实践?第四节 支架的类型重要吗?第十三章 外科治疗引言节 外科血运重建一、患者评估和选择二、术前评估三、围手术期和麻醉注意事项四、术后管理第二节 颅外手术选择一、椎动脉-颈动脉转位术二、颅外颈动脉-椎动脉血管吻合术三、骨质增生椎间孔减压术第三节 颅内手术选择一、经颞浅动脉至大脑后动脉或小脑上动脉的血管吻合术二、经枕动脉至小脑后下动脉或小脑前下动脉吻合术第四节 卒中减压术一、背景和适应证二、枕下去骨瓣减压术和脑室外引流术第十四章 非动脉粥样硬化少见疾病节 夹层一、临床表现二、梭形扩张(动脉冗扩)三、动脉压迫第二节 肌纤维发育不良一、烟雾病二、偏头痛三、可逆性脑血管收缩综合征四、线粒体疾病五、多发性大动脉炎六、巨细胞(颞)动脉炎七、其他感染性或免疫性血管炎第十五章 结局与预后节 椎基底动脉缺血性卒中的发病机制第二节 早期结果: 前90天一、复发性卒中二、死亡或伤残三、临床结局预测因素第三节 晚期结果: 一年以后名词索引
在医学生时代,我很惊讶地看到教授们仅仅通过患者的眼球和感觉运动就可以定位脑干病变。由于脑干解剖和功能相当复杂,其研究工作相当烦琐。然而,这一挑战本身激励我成为一名神经科医生,并在职业生涯中持续激发我的兴趣。 然而,在我的教授生涯中,我意识到,与前循环卒中相比,后循环卒中并没有得到足够的重视。医学生、住院医师甚至一些教授都没有花足够的时间去了解这种疾病的临床症状和发病机制,这种情况也存在于一些研究者中。即便急性基底动脉闭塞可导致极其严重的神经功能障碍,在研究静脉溶栓和血管内治疗效果的大型临床实验中,后循环卒中仍旧屡遭忽视。 得益于卡普兰等先驱者创造的理论学说,我们现在可以更好地理解后循环卒中。然而,我始终坚信应该有更多的文献报道。我的个人从业经验以及相关文献对后循环卒中和前循环卒中的比较研究都提示这两种不同部位的病变仍有一些相同之处。后循环卒中常与动脉病变相关,而前循环卒中常由于心源性栓塞所致。后循环卒中的缺血范围较小,起病方式较缓。虽然鲜有报道,但如果可以实现对这种复杂病变的快速诊断和及时评估,动脉取栓应当是有效的。考虑其病变特点,后循环卒中的治疗时间窗甚至可能比前循环卒中更长。治疗小动脉病变的新技术促进了我们对于后循环卒中的理解和管理。 本书旨在为读者提供全面和的后循环卒中知识,包括血管解剖、病理学、流行病学、发病机制、临床表现(包括视觉和听觉障碍)、诊断方式和治疗策略,比如抗血栓治疗、血管成形术、支架成形术以及外科手术。此外,该书还广泛探讨了一些非动脉粥样硬化性疾病,如动脉夹层、血管炎以及其他病变。因此,此书涵盖了从基础研究到临床实践的多种主题,所有章节均由国际知名专家和科学家撰写。在我看来,这些前沿的研究进展,比如高分辨率磁共振成像和血管内治疗技术将极大地激发读者的兴趣。 我们必须承认,即便做了大量的研究,积累了充分的事实,某些领域依旧没有定论。的药物治疗方案,哪些患者可从血管成形术、支架成形术以及搭桥手术中获益,血管内再通的时间窗等问题,仍值得进一步研究。我希望这本书集信息性、趣味性和启发性于一体,并可作为他们在临床和科研工作中实用的指南。后,我衷心感谢所有撰稿人为本书所付出的宝贵时间和努力,我也感谢施普林格为我提供了与全世界读者交流的机会。 Jong S.Kim于韩国首尔
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