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创伤性椎动脉夹层导致不完全一致的同向上象限盲。

Traumatic vertebral artery dissection presenting with incomplete congruous homonymous quadrantanopia.

机构信息

Department of Ophthalmology, Flinders Medical Centre, Flinders University, Flinders Drive, Bedford Park, Adelaide SA 5042, Australia.

出版信息

BMC Ophthalmol. 2010 May 19;10:14. doi: 10.1186/1471-2415-10-14.

DOI:10.1186/1471-2415-10-14
PMID:20482837
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2885997/
Abstract

BACKGROUND

To describe a rare presentation of vertebral artery dissection (VAD) as a small but congruous incomplete homonymous hemianopia demonstrating use of visual field testing in the diagnosis.

CASE PRESENTATION

A 30 year old woman had been unwell for 4 months with difficulty focusing, vertigo, dizziness and a feeling of falling to the right. A small but congruous right inferior homonymous quadrantanopia was found on examination leading to further investigation that uncovered a vertebral artery dissection and multiple posterior circulation infarctions including a left occipital stroke matching the field defect.

CONCLUSIONS

We describe an atypical case of VAD presenting with a small congruous quadrantanopia. This is a rare but significant condition that predisposes to multiple thromboembolic infarction that may be easily misdiagnosed and a high index of suspicion is required to make the diagnosis.

摘要

背景

描述一种罕见的椎动脉夹层(VAD)表现为小但一致的不完全同向偏盲,展示了视野检查在诊断中的应用。

病例介绍

一名 30 岁女性,持续 4 个月出现难以集中注意力、眩晕、头晕和向右侧摔倒的感觉。检查发现右侧下象限同向偏盲较小但一致,进一步检查发现椎动脉夹层和多个后循环梗死,包括与视野缺陷相匹配的左侧枕叶中风。

结论

我们描述了一例不典型的 VAD 病例,表现为小的一致象限偏盲。这是一种罕见但重要的情况,易导致多发血栓栓塞性梗死,可能容易误诊,需要高度怀疑以做出诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55fe/2885997/7f1a6d079813/1471-2415-10-14-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55fe/2885997/7d9fafccf1d4/1471-2415-10-14-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55fe/2885997/7f1a6d079813/1471-2415-10-14-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55fe/2885997/7d9fafccf1d4/1471-2415-10-14-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55fe/2885997/7f1a6d079813/1471-2415-10-14-2.jpg

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Cervical arterial dissection: current concepts .颈动脉硬化夹层:当前概念
Ann N Y Acad Sci. 2008 Oct;1142:200-17. doi: 10.1196/annals.1444.015.
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Comparison of multidetector CT angiography and MR imaging of cervical artery dissection.多层螺旋CT血管造影与磁共振成像对颈动脉夹层的比较。
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Treatment of cervical artery dissection: a systematic review and meta-analysis.颈内动脉夹层的治疗:一项系统评价与荟萃分析。
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MDCT angiography for detection and quantification of small intracranial arteries: comparison with conventional catheter angiography.多层螺旋CT血管造影术用于检测和定量分析颅内小动脉:与传统导管血管造影术的比较
AJR Am J Roentgenol. 2007 Feb;188(2):593-602. doi: 10.2214/AJR.05.2143.