Demiryoguran N S, Karcioglu O, Topacoglu H, Aksakalli S
Department of Emergency Medicine, School of Medicine, Dokuz Eylul University, 35340, Inciralti, Izmir, Turkey.
Emerg Med J. 2006 Feb;23(2):e15. doi: 10.1136/emj.2005.027862.
A 63 year-old woman was admitted to the emergency department with vertigo, nausea, and vomiting. On arrival, she was fully oriented and cooperative. She denied any pain in her chest, neck, back, or abdomen. A bruit was heard on both sides of her neck. Cranial computed tomography (CT) revealed no abnormality, while thoracic CT disclosed dissection in the ascending aorta, aortic arch, and bilateral common carotid arteries. After several hours, the patient underwent vascular surgery. She had an uneventful course and was discharged without any sequelae after 10 days. Vertigo is a rare presentation of aortic dissection with carotid involvement. Elderly patients presented with vertigo and nausea/vomiting should be evaluated for the condition and carotid dissection should be ruled out. Carotid bruit may be a clue to the diagnosis.
一名63岁女性因眩晕、恶心和呕吐被送往急诊科。入院时，她神志清醒且配合。她否认胸部、颈部、背部或腹部有任何疼痛。颈部两侧可闻及血管杂音。头颅计算机断层扫描（CT）未发现异常，而胸部CT显示升主动脉、主动脉弓和双侧颈总动脉夹层。数小时后，患者接受了血管手术。她恢复顺利，10天后出院，无任何后遗症。眩晕是主动脉夹层累及颈动脉的罕见表现。对于出现眩晕和恶心/呕吐的老年患者，应评估是否患有此病，并排除颈动脉夹层。颈动脉杂音可能是诊断的线索。
