Komiyama M, Morikawa T, Nakajima H, Nishikawa M, Yasui T
Department of Neurosurgery, Osaka City General Hospital.
Neurol Med Chir (Tokyo). 2000 Jun;40(6):310-4. doi: 10.2176/nmc.40.310.
Spontaneous dissection of the extracranial vertebral artery (VA) may cause ischemic stroke in the posterior circulation. A 22-year-old female and a 38-year-old male presented with sudden onset of vertigo and nausea without trauma. Angiography was initially interpreted as normal, but retrospective examination disclosed extracranial VA dissection in the V3 segment in both cases. Arterial dissection resulting in embolic stroke in the territory of the ipsilateral posterior inferior cerebellar artery was highly suspected. Both patients were treated conservatively without sequelae. Careful angiographic interpretation is important for the diagnosis of extracranial VA dissection. Spontaneous extracranial VA dissection should be suspected in young patients presenting with ischemic stroke but without predisposing risk factors or associated trauma.
颅外椎动脉（VA）自发性夹层可能导致后循环缺血性卒中。一名22岁女性和一名38岁男性在无外伤情况下突然出现眩晕和恶心。血管造影最初被解读为正常，但回顾性检查发现两例患者的V3段均存在颅外VA夹层。高度怀疑动脉夹层导致同侧小脑后下动脉供血区发生栓塞性卒中。两名患者均接受保守治疗，无后遗症。仔细的血管造影解读对于颅外VA夹层的诊断很重要。对于出现缺血性卒中但无易患危险因素或相关外伤的年轻患者，应怀疑存在自发性颅外VA夹层。
