腔隙性脑梗死与脑小血管病的关系

摘要

腔隙性脑梗死是一个直径＜15 mm的缺血性梗死,分布于脑穿支动脉的供血区.腔隙性脑梗死的典型特征是无症状的小血管疾病发展过程,通常将腔隙性脑梗死冠以脑小血管病的称谓,这混淆了腔隙性脑梗死与脑小血管病的定义,从TOAST分型中的小动脉闭塞,ASCO分型中的小血管疾病到CISS分型的穿支动脉疾病,可以看出人们对这两对概念的逐渐深入.该文以腔隙性脑梗死为主线,目的 在于总结目前关于腔隙性脑梗死的责任血管发病机制、病理生理过程及危险因素,从而揭示腔隙性脑梗死与脑小血管病变的关系,对预后和治疗方面给予新的启示.%Lacunar infarction is an ischemic infarction of less than 15 mm in diameter,located in the distribution territory of a cerebral penetrating arteriole.The typical characteristics of lacunar infarction is asymptomatic small vessel disease development process, and lacunar infarction is usually named as a small vascular disease, which confuses the definition of lacunar infarction and cerebral small vascular disease.From the small artery occlusion in the TOAST classification, small vessel disease in the ASCO classification to C1SS typing of the perforating artery disease,the gradual deepening understanding of the two concepts.Now, taking the lacunar infarction as a main line, here is to summarize lacunar infarction responsible vascular pathogenesis, pathophysiology process and risk factors, to reveal the relationship between lacunar infarction and cerebral vascular disease, and give a new revelation to the prognosis and treatment.