Kenny R A, Traynor G
Royal Victoria Infirmary, Newcastle upon Tyne.
Age Ageing. 1991 Nov;20(6):449-54. doi: 10.1093/ageing/20.6.449.
Carotid sinus massage was carried out on 130 consecutive patients referred for investigation of dizziness, syncope or unexplained falls. Carotid sinus syndrome was diagnosed in 33 for whom no other cause of symptoms was identified. Right-sided hypersensitivity was more frequent than left-sided. Thirty per cent identified a prodrome before syncope and 30% had retrograde amnesia for the event. In 52%, symptoms were precipitated by head movement and in 48% by vagal stimuli. Seven described 'drop attacks' but symptoms were reproduced with carotid sinus massage during head-up tilt. Injuries, including fractured neck of femur, were sustained by the majority. Carotid sinus massage should be performed routinely on all elderly patients who have symptoms of unexplained dizziness, falls or syncope. Cardiac pacing relieves syncopal symptoms in those with a predominant cardio-inhibitory response and recurrent syncope.
对130例因头晕、晕厥或不明原因跌倒前来就诊的连续患者进行了颈动脉窦按摩。在33例未发现其他症状原因的患者中诊断出颈动脉窦综合征。右侧过敏比左侧更常见。30%的患者在晕厥前有前驱症状，30%的患者对该事件有逆行性遗忘。52%的症状由头部运动诱发，48%由迷走神经刺激诱发。7例描述有“跌倒发作”，但在头高位倾斜时进行颈动脉窦按摩可再现症状。大多数患者有包括股骨颈骨折在内的损伤。对于所有有不明原因头晕、跌倒或晕厥症状的老年患者，应常规进行颈动脉窦按摩。心脏起搏可缓解以心脏抑制反应为主且反复晕厥的患者的晕厥症状。
