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青少年症状性颅内动脉夹层的支架置入治疗

Stent placement for the treatment of a symptomatic intracranial arterial dissection in an adolescent.

作者信息

Binning Mandy J, Khalessi Alexander A, Siddiqui Adnan H, Hopkins L Nelson, Levy Elad I

机构信息

Department of Neurosurgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA.

出版信息

J Neurosurg Pediatr. 2010 Aug;6(2):154-8. doi: 10.3171/2010.4.PEDS1081.

Abstract

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.

摘要

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。

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