Nakatomi H, Nagata K, Kawamoto S, Furusho J I
Department of Neurosurgery, Showa General Hospital, Tokyo, Japan.
Acta Neurochir (Wien). 1999;141(1):99-104. doi: 10.1007/s007010050272.
Basilar artery occlusion (BAO) causing brainstem infarction occurred in a 7-year-old boy without any basic disorders. A diagnosis of BAO due to basilar artery dissection (BAD) was suspected at angiography, and this was confirmed by gadolinium-enhanced magnetic resonance imaging (MRI). These investigations clearly showed all the typical diagnostic signs such as a pseudolumen, double lumen and intimal flap, and a pseudolumen in resolution. The spontaneous healing of the dissection was clearly demonstrated during 10 months of follow-up. We stress that BAD can occur in young children and that combined diagnosis with gadolinium-enhanced MRI and angiography is conclusive for diagnosis of dissecting aneurysms. Wider use of these combined diagnostic methods will allow the detection of less severe basilar artery dissection, thus extending the spectrum of presentation and prognosis.
一名7岁男孩在无任何基础疾病的情况下发生基底动脉闭塞（BAO）并导致脑干梗死。血管造影时怀疑是由基底动脉夹层（BAD）引起的BAO，钆增强磁共振成像（MRI）证实了这一诊断。这些检查清楚地显示了所有典型的诊断征象，如假腔、双腔和内膜瓣，以及正在消退的假腔。在10个月的随访中清楚地显示了夹层的自发愈合。我们强调BAD可发生于儿童，钆增强MRI和血管造影联合诊断对夹层动脉瘤的诊断具有决定性意义。更广泛地使用这些联合诊断方法将有助于发现不太严重的基底动脉夹层，从而扩大临床表现和预后的范围。
