Camacho A, Villarejo A, de Aragón A M, Simón R, Mateos F
Section of Pediatric Neurology, Hospital Doce de Octubre;, Madrid, Spain.
Pediatr Neurol. 2001 Sep;25(3):250-3. doi: 10.1016/s0887-8994(01)00294-6.
Carotid and vertebral artery dissection is a rarely reported cause of stroke in childhood and adolescence, especially if there is not a direct trauma to the neck. Four patients, under 15 years of age, presented with an internal carotid artery dissection, and one patient presented with a vertebral artery dissection. They were all making a physical effort when the event occurred. The five patients had ischemic symptoms, and in two the events were preceded by transient ischemic attacks. Headache was associated in four patients. The diagnosis was made by magnetic resonance imaging and angiography, which included transfemoral angiography in two patients. All improved before leaving the hospital, and four patients did not suffer recurrent episodes. The diagnostic accuracy of artery dissection has improved because of noninvasive neuroimaging testing, but it should still be suspected in any pediatric ischemic stroke, especially if there is headache or cervical pain associated.
颈动脉和椎动脉夹层是儿童和青少年期卒中的一种罕见病因，尤其是在没有颈部直接创伤的情况下。4例15岁以下患者出现颈内动脉夹层，1例出现椎动脉夹层。事件发生时他们均在进行体力活动。这5例患者均有缺血症状，其中2例在事件发生前有短暂性脑缺血发作。4例患者伴有头痛。诊断通过磁共振成像和血管造影做出，其中2例患者还进行了经股动脉血管造影。所有患者在出院前均有改善，4例患者未出现复发。由于无创神经影像学检查，动脉夹层的诊断准确性有所提高，但在任何小儿缺血性卒中中仍应怀疑此病，尤其是伴有头痛或颈部疼痛时。
