Acceptable, good quality SGBV medical care can be provided in large cities of sub-Saharan Africa, although further work is needed to improve follow-up interventions.
The blood supply of the brain presents very particular characteristics when compared with that of most other internal organs. Indeed, the brain is enveloped by a network of leptomeningeal arteries, coming from afferent trunks, which remain outside the brain and fuse into the circle of Willis. From this peripheral network, the intracerebral arteries penetrate perpendicularly into the parenchyma, converging centripetally and radially towards the ventricle. This organization is completely different from that present in most other organs: in the latter, the main trunks penetrate by the way of a hilus into the center of the organ, from where they centrifugally irrigate the parenchyma.The vascularization pattern of the brain is consequently an essentially centripetal one, and in several publications, 1-7 we described its modalities.These centripetal intracerebral arteries can be classified in three groups: rami corticales, rami medullares and rami striati. The rami corticales end in the cortex or immediately beneath it. The rami medullares supply the white substance: they radially converge towards the nearest point of the ventricular wall, which, however, is rarely reached. From an angioarchitectonic viewpoint, these arteries are substantially influenced by the local arrangement of nervous fibers and by the glial infrastructure of the white matter. The rami striati, which supply the gray nuclei and the capsula interna, are larger than the rami medullares; the longest among them reach closely to the ventricle.Our research on the deep intracerebral blood supply revealed, besides the centripetal vascular system, the existence of centrifugal elements, although to some extent secondary. «Te are convinced, however, that this centrifugal vascular system presents a significant practical importance, which we would like to discuss. LOCALIZATION AND TERRITORYThe centrifugal arterioles originate from subependymal arteries. The latter are branches of the several arteriae chorioideae and also of certain terminal branches of the rami striati. They penetrate into the brain parenchyma recurrently, diverging ventriculofugally and radially (fig.
Son r61e 6ventuel dans la pathog6nie de l'h6matome intrac6r6bral spontan6Par R. Van den BerghAvee 10 figures Plusieurs auteurs ont 6tudi6 d'une fagon d6taill6e l'angioarchitecture du cortex c6r6bral. Par contre des 6tudes similaires portant sur la substance blanche n'apportent que des d0nn6es sporadiques et ineompl6tes.Au cours de l'6tude syst6matique que nous effeetuons de eette angioarchitecture interne ou souscorticale, nous avons 6t6 frapp6 par la disposition vasculaire tr6s remarquable et tr6s partieuli6re des radiations optiques. Dans cette communication nous essayerons de r6sumer quelques unes de ees donn6es. Nous esp6rons en mSme temps mettre en 6videnee certains 61~ments qui sont probabtement li6s fi la pathog6nie de l'h6matome intra-c6r6bral spontan6. Ce dernier se retrouve habituetlement dans la substance blanche de la r6gion temporo-occipitale et dans le voisinage imm6diat de la paroi ventriculaire. Son. expression clinique le diff6reneie nettement de l'h6morragie capsulo-lenticulaire classique. L'h6matome intrac6r~bral est caract6ris6 notamment par l'apparition presque constante d'une h6mianopsie homonyme. I1 refoule le tissu c6r6bral sans l'infiltrer et peut ~tre 6vacu6 par une intervention neuro-chirurgicale.
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