Rohr-Le Floch J
Clinique de Neurologie, Hôpital Cantonal Universitaire, Genève.
Schweiz Arch Neurol Psychiatr (1985). 1991;142(4):319-39.
By means of transcranial Doppler (TCD), the author reports intracranial haemodynamic consequences of 57 stenosis or occlusions of the internal carotid artery (ICA), 13 dissections and 44 atheromatous lesions, in 50 patients 32 of whom having had angiography. If a stenosis is significant, the curve of the middle cerebral artery (MCA) becomes dampened and PTI (Pulsatility Transmission Index) diminishes. In this series, the association MCA curve dampened and PTI lower than 0.90 is the evidence of a more than 90% stenosis, except in 2 atheromatous and symptomatic occlusions. No precise explanation for these exceptions is given by literature. An ICA stenosis has also an influence on communicating arteries. In this study, collateralisation by the circle of Willis exists in 14% of 50-75% stenosis, 72.7% of 75-90% stenosis and 100% of more than 90% stenosis. It can depend on anterior communicating artery (ACoA) alone, posterior communicating artery (PCoA) alone or both. Detailed study of the 3 groups leads to the hypothesis of a hierarchy in the function of the communicating arteries, ACoA having the priority.
作者通过经颅多普勒（TCD）报告了50例患者颅内血流动力学的变化情况，这些患者中，57例存在颈内动脉（ICA）狭窄或闭塞，13例有动脉夹层，44例有动脉粥样硬化病变，其中32例进行了血管造影。若狭窄严重，大脑中动脉（MCA）曲线会变钝，搏动传递指数（PTI）降低。在本系列研究中，除2例动脉粥样硬化性和有症状的闭塞外，MCA曲线变钝且PTI低于0.90可作为超过90%狭窄的证据。文献中未对这些例外情况给出确切解释。ICA狭窄对交通动脉也有影响。在本研究中，50% - 75%狭窄的患者中14%存在 Willis 环侧支循环，75% - 90%狭窄的患者中72.7%存在，超过90%狭窄的患者中100%存在。侧支循环可单独依赖前交通动脉（ACoA）、后交通动脉（PCoA）或两者。对这三组的详细研究得出交通动脉功能存在层级关系的假设，即ACoA具有优先性。
