Jariwala Sunit P, Crowley J Gerard, Roychowdhury Sudipta
Albert Einstein/Montefiore Medical Center, Bronx, NY, USA.
Pediatr Emerg Care. 2006 Oct;22(10):737-42. doi: 10.1097/01.pec.0000236835.46818.0c.
Carotid artery dissections (CADs) represent an uncommon clinical condition that should be considered in the differential diagnosis of young individuals presenting with symptoms of stroke. The basic pathological changes in CAD include a disruption in the media or intima of arterial wall, through which the affected vasculature is predisposed to aneurysm or stenosis, and subsequent stroke. Carotid artery dissection may occur spontaneously or result from trauma, an underlying arteriopathic condition, or predisposing risk factors. The heterogeneous clinical presentations of CAD represent significant diagnostic difficulties, which often lead to delays in diagnosis and treatment. Further complicating the clinical picture is the lack of consensus regarding effective treatment modalities. Because of the often-subtle findings present in CAD, the treating physician must have a high index of suspicion to accurately diagnose and manage the condition. We report extracranial internal CAD in a 17-year-old girl leading to multiple infarcts that was successfully managed with initial antiplatelet therapy and subsequent anticoagulation.
颈动脉夹层（CADs）是一种不常见的临床病症，在对出现中风症状的年轻人进行鉴别诊断时应予以考虑。CAD的基本病理变化包括动脉壁中膜或内膜的破坏，受影响的血管由此易发生动脉瘤或狭窄，进而导致中风。颈动脉夹层可能自发出现，也可能由创伤、潜在的动脉病变或易感风险因素引起。CAD的临床表现多种多样，给诊断带来了很大困难，常常导致诊断和治疗延误。关于有效治疗方式缺乏共识，这使临床情况更加复杂。由于CAD的表现往往很隐匿，治疗医生必须保持高度的怀疑指数，才能准确诊断和处理这种病症。我们报告了一名17岁女孩发生的颅外颈内动脉夹层，导致多处梗死，通过初始抗血小板治疗和随后的抗凝治疗成功得到控制。
