Chang A J, Mylonakis E, Karanasias P, De Orchis D F, Gold R
Department of Medicine, Miriam Hospital, Brown University School of Medicine, Providence, RI 02906, USA.
Mayo Clin Proc. 1999 Sep;74(9):893-6. doi: 10.4065/74.9.893.
Vertebral artery dissection (VAD) has been increasingly identified as a cause of ischemic stroke in young adults. We report the clinical and radiographic findings in a case of spontaneous bilateral VADs and review the literature on the causes, pathophysiology, diagnostic considerations, and treatment options for VAD. A 29-year-old man was admitted to our hospital after sudden onset of headache and nuchal rigidity that progressed to a posterior lateral medullary syndrome in a 2-week period. The diagnosis of bilateral VADs was based on findings on cranial magnetic resonance imaging and conventional angiography. The patient was given anticoagulant therapy and had no further neurologic deterioration. The differential diagnosis of craniocervical pain in young patients should include arterial dissection of the neck because early diagnosis and treatment may reduce the chances of long-term neurologic sequelae.
椎动脉夹层（VAD）越来越多地被认为是年轻人缺血性卒中的一个病因。我们报告一例自发性双侧VAD的临床和影像学表现，并回顾关于VAD的病因、病理生理学、诊断要点及治疗选择的文献。一名29岁男性在突发头痛和颈部强直后2周内进展为延髓背外侧综合征，随后入住我院。双侧VAD的诊断基于头颅磁共振成像和传统血管造影的结果。该患者接受了抗凝治疗，未出现进一步的神经功能恶化。年轻患者颅颈疼痛的鉴别诊断应包括颈部动脉夹层，因为早期诊断和治疗可能会减少长期神经后遗症的发生几率。
