Binning Mandy J, Khalessi Alexander A, Siddiqui Adnan H, Hopkins L Nelson, Levy Elad I
Department of Neurosurgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA.
J Neurosurg Pediatr. 2010 Aug;6(2):154-8. doi: 10.3171/2010.4.PEDS1081.
Intracranial arterial dissection is an important cause of stroke in young patients. Treatment options include observation, antiplatelet or anticoagulation regimens, and endovascular stent placement. The authors describe the case of a 14-year-old boy who presented with a symptomatic, posttraumatic dissection extending from the intracranial internal carotid artery to the middle cerebral artery. Images obtained approximately 48 hours after this incident revealed a subacute right frontal lobe infarct, and a CT stroke study (CT angiography and CT perfusion) confirmed the vascular injury and associated decreased perfusion, prompting revascularization with a self-expanding stent. The patient did well clinically after stent placement and showed no evidence of restenosis on follow-up angiography 3 and 6 months later. This report is, to the authors' knowledge, the first description of the use of a stent for a symptomatic intracranial dissection in an adolescent.
颅内动脉夹层是年轻患者卒中的重要病因。治疗选择包括观察、抗血小板或抗凝治疗方案以及血管内支架置入。作者描述了一名14岁男孩的病例,该男孩出现了有症状的创伤后夹层,从颅内颈内动脉延伸至大脑中动脉。事件发生约48小时后获得的影像显示右额叶亚急性梗死,CT卒中检查(CT血管造影和CT灌注)证实了血管损伤及相关的灌注降低,促使采用自膨式支架进行血管重建。支架置入后患者临床情况良好,在3个月和6个月后的随访血管造影中未显示再狭窄迹象。据作者所知,本报告是对青少年有症状颅内夹层使用支架的首次描述。