Early T F, Gregory R T, Wheeler J R, Snyder S O, Gayle R G, Parent F N, Sorrell K
Division of Vascular Surgery, Eastern Virginia Graduate School of Medicine, Norfolk.
J Vasc Surg. 1991 Sep;14(3):391-7. doi: 10.1067/mva.1991.30273.
The clinical, duplex, and angiographic findings in six patients with seven spontaneous extracranial carotid artery dissections are reported. Four dissections resulted in internal carotid artery occlusion. These patients complained of ipsilateral headache followed by contralateral hemiplegia. The other three dissections involved the common carotid artery and resulted in dual (one true and one false) lumens. Two of these dissections were asymptomatic. All dissections were treated nonoperatively with anticoagulant therapy. Neurologic deficits improved or disappeared in all symptomatic patients. On follow-up studies, one of the four internal carotid occlusions completely resolved with normalization of the duplex examination. All three dual lumen dissections remained patent on serial studies. Diagnostic duplex characteristics, both conclusive and supportive, of carotid dissections are described. Duplex scanning is shown to be accurate in diagnosing and ideally suited for serially following spontaneous carotid dissections.
报告了6例患者7处自发性颅外颈动脉夹层的临床、双功超声和血管造影结果。4处夹层导致颈内动脉闭塞。这些患者先出现同侧头痛，随后出现对侧偏瘫。另外3处夹层累及颈总动脉，形成双腔（一个真腔和一个假腔）。其中2处夹层无症状。所有夹层均采用抗凝治疗，未行手术。所有有症状的患者神经功能缺损均有改善或消失。在随访研究中，4例颈内动脉闭塞中有1例双功超声检查恢复正常，闭塞完全消失。3例双腔夹层在系列研究中均保持通畅。描述了颈动脉夹层的诊断性双功超声特征，包括确诊性和支持性特征。双功超声扫描在诊断自发性颈动脉夹层方面准确无误，非常适合对其进行系列随访。
