Mokri B, Schievink W I, Olsen K D, Piepgras D G
Department of Neurology, Mayo Clinic, Rochester, MN 55905.
Arch Otolaryngol Head Neck Surg. 1992 Apr;118(4):431-5. doi: 10.1001/archotol.1992.01880040097016.
Spontaneous dissections of the internal carotid arteries are uncommon but are not rare. They constitute a fairly common cause of ischemic stroke in young patients (young in terms of the age at which strokes generally occur). The common presenting manifestations are (1) unilateral headaches followed after a period of delay by focal cerebral ischemic symptoms or (2) unilateral headaches and ipsilateral incomplete Horner's syndrome. These may or may not be associated with subjective or objective bruits. In rare instances, spontaneous dissections of the internal carotid arteries may present as lower cranial nerve palsies and cause dysphonia, dysarthria, dysphagia, and numbness of the throat. Affected patients may initially present to the otolaryngologist or be referred to one. This article describes eight patients with spontaneous dissections of the internal carotid arteries and lower cranial nerve palsies, and the pertinent literature is reviewed.
颈内动脉自发性夹层并不常见，但也并非罕见。它们是年轻患者缺血性卒中的一个相当常见的病因（这里的年轻是相对于卒中通常发生的年龄而言）。常见的临床表现为：（1）单侧头痛，经过一段时间后出现局灶性脑缺血症状；或（2）单侧头痛和同侧不完全霍纳综合征。这些症状可能伴有或不伴有主观或客观的血管杂音。在罕见情况下，颈内动脉自发性夹层可能表现为低位颅神经麻痹，导致声音嘶哑、构音障碍、吞咽困难和咽喉部麻木。受影响的患者最初可能就诊于耳鼻喉科医生或被转诊至该科室。本文描述了8例颈内动脉自发性夹层伴低位颅神经麻痹的患者，并对相关文献进行了综述。
