Manz H J, Vester J, Lavenstein B
Virchows Arch A Pathol Anat Histol. 1979 Oct;384(3):325-35. doi: 10.1007/BF00428233.
A nine year old girl died with a massive infarct of the right cerebral hemisphere causing transtentorial and foramen magnum herniation. The infarction was secondary to an idiopathic dissecting aneurysm. The case is unusual in that the supraclinoid segment of the right internal carotid artery, the anterior cerebral artery, and the middle cerebral artery and its three branches were embedded and sectioned longitudinally. The dissection commenced in the supraclinoid segment of the right internal carotid artery, extended into the middle and anterior cerebral arteries, and was accompanied by thrombosis of the false lumen. A literature review of 20 pediatric cases indicates the malignant natural course of the disease (76% mortality in the first two months), and emphasizes the characteristic angiographic "string sign". The diagnosis of cerebral arterial dissection during life depends on angiography and a high index of suspicion.
一名9岁女孩死于右侧大脑半球大面积梗死，导致经小脑幕和枕骨大孔疝形成。该梗死继发于特发性夹层动脉瘤。该病例的不同寻常之处在于，右侧颈内动脉床突上段、大脑前动脉、大脑中动脉及其三个分支均被包埋并纵向切片。夹层始于右侧颈内动脉床突上段，延伸至大脑中动脉和大脑前动脉，并伴有假腔血栓形成。对20例儿科病例的文献综述表明了该疾病的恶性自然病程（头两个月死亡率为76%），并强调了特征性的血管造影“串珠征”。生前诊断脑动脉夹层依赖于血管造影和高度的怀疑指数。
