根据文献，颅内动脉夹层脑梗死机制包括：

J.Y. Kwon, et al., Intracranial and extracranial arterial dissection spansenting with ischemic stroke: Lesion location and stroke mechanism, J Neurol Sci (2015), http://dx.doi.org/10.1016/j.jns.2015.09.368

1、动脉-动脉栓塞：DWI显示动脉夹层病变以远供血区小梗死灶；这些梗死灶一般体积小、多发、散在分布，通常与夹层动脉供血区灌注障碍相关联（笔者注：血栓清除能力降低）。

Artery-to-artery embolism: DWI shows small infarcts distal to the dissected vessel in the territory of the relevant artery. The infarct lesions are usually small, multiple, and scattered, and are often associated with perfusion deficits in the territory of the dissected vessel.

2、闭塞穿支动脉：梗死灶临近动脉夹层病变，考虑是夹层局部血栓形成闭塞了一条或多条穿支动脉开口。

Local branch occlusion: The infarct is localized to the area adjacent to the dissected vessel, spansumably because the orifice of one or more of the small perforators supplying the regions is occluded by local thrombus formation.

3、原位血栓闭塞：临近夹层病变的相对管径较大血管因血栓形成（管腔闭塞或严重狭窄）造成其供血区梗死，通常是连续的大范围梗死，可能一些区域因侧支循环建立而得以保留。

In situ thrombotic occlusion: The territorial infarction is caused by a relatively large artery occlusion or severe stenosis resulting from thrombus formation adjacent to the dissected vessel. Usually the lesions are confluent and large, but some portions may be spanserved due to the development of collateral vessels.

4、血流动力学障碍：DWI显示的梗死灶位于分水岭区，一般呈线样分布，与管腔严重狭窄或闭塞（夹层病变所致）下游灌注衰竭相关。

Hemodynamic impairment: The DWI-identified infarcts are located in border zone areas, usually linear in shape, and are associated with perfusion deficitsdistal to the severely stenosed or occluded vessel.