因颅外小脑后下动脉夹层导致的整脊手法治疗后中风
Stroke after chiropractic manipulation as a result of extracranial postero-inferior cerebellar artery dissection.
作者信息
Sédat J, Dib M, Mahagne M H, Lonjon M, Paquis P
机构信息
Department of Neuroradiology, CHU de Nice, Hôpital St. Roch, Nice, France.
出版信息
J Manipulative Physiol Ther. 2002 Nov-Dec;25(9):588-90. doi: 10.1067/mmt.2002.128955.
OBJECTIVE
To describe a case of dissection of the postero-inferior cerebellar artery (PICA) after cervical manipulation.
CLINICAL FEATURES
After cervical manipulation, a 42-year-old woman had a cerebellar syndrome related to an infarct in the area supplied by the PICA, confirmed by computed tomography of the brain. Cerebral angiography showed a normal appearance of the vertebral artery, a cervical extradural origin of PICA, and a dissection of the latter at the C1-C2 level.
INTERVENTION AND OUTCOME
Anticoagulant treatment with heparin was implemented. A positive outcome was achieved after 3 weeks.
CONCLUSION
Anatomical variations of the vertebral arteries and their branches are not infrequent and may constitute a predisposing factor to complications after neck manipulation.
目的
描述一例颈椎手法治疗后小脑后下动脉（PICA）夹层的病例。
临床特征
颈椎手法治疗后，一名42岁女性出现与PICA供血区梗死相关的小脑综合征，脑部计算机断层扫描证实了这一点。脑血管造影显示椎动脉外观正常，PICA起源于颈椎硬膜外，且在C1 - C2水平处发生夹层。
干预措施及结果
采用肝素进行抗凝治疗。3周后取得了良好的效果。
结论
椎动脉及其分支的解剖变异并不罕见，可能是颈部手法治疗后并发症的一个诱发因素。
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