Anson J, Crowell R M
Department of Neurosurgery, University of Illinois, Chicago.
Neurosurgery. 1991 Jul;29(1):89-96. doi: 10.1097/00006123-199107000-00015.
Dissection of the cervicocranial arteries is becoming more frequently recognized as a cause of neurological disorders. Typical clinical features seen with dissection include unilateral headache, oculosympathetic palsy, amaurosis fugax, and symptoms of focal brain ischemia. The diagnosis of carotid or intracranial dissection is usually best confirmed by angiography, although magnetic resonance imaging and computed tomography have been shown to visualize intimal dissection. The prognosis in cases of spontaneous dissection is generally benign unless the initial manifestation involves infarction with substantial deficit. The best approach to treatment appears to be the administration of the anticoagulant, heparin, followed by warfarin or antiplatelet therapy. Surgical intervention is reserved for cases of progressive or recurrent ischemic complication that occurs despite the administration of adequate doses of anticoagulants.
颈颅动脉夹层越来越多地被认为是神经系统疾病的一个病因。夹层常见的典型临床特征包括单侧头痛、眼交感神经麻痹、一过性黑矇以及局灶性脑缺血症状。虽然磁共振成像和计算机断层扫描已被证明可显示内膜夹层，但颈动脉或颅内夹层的诊断通常最好通过血管造影来确诊。除非初始表现为伴有严重功能缺损的梗死，否则自发性夹层病例的预后一般良好。最佳的治疗方法似乎是给予抗凝剂肝素，随后给予华法林或抗血小板治疗。对于尽管给予了足够剂量的抗凝剂仍发生进行性或复发性缺血性并发症的病例，则保留手术干预。
