d'Anglejan Chatillon J, Ribeiro V, Mas J L, Bousser M G, Laplane D
Hôpital André Mignot, Service de Médecine, Le Chesnay.
Presse Med. 1990 Apr 7;19(14):661-7.
The results of a study of 62 patients with 69 dissections of the extracranial internal carotid artery are presented. Mean age at the time of diagnosis was 43 years, with a preponderance of men over women. The patients were followed up for a mean period of 41 months. In 6 cases regarded as being "traumatic" in origin, the outcome was similar to that of "spontaneous" dissection. The most significant associated factors seemed to be migraine (34 per cent), on-going treatment with oestrogens and progestogens (48 per cent of women) and fibromuscular dysplasia (21 per cent). The clinical features consisted of local signs (isolated in 8 cases), signs of ischaemia (isolated in 9 cases) or both together. There were 35 established cerebral vascular accidents and 2 cases of ischaemic optic neuritis with blindness, responsible for invalidating sequelae in 31 per cent of the patients. The most frequent local signs were suggestive hemicrania, cervical pain, Horner syndrome and tinnitus. The initial angiography showed occlusion in one quarter of the cases and stenosis in 70 per cent. Stenosis was usually located in the second infrapetrosal half of the artery and had the most favourable angiographic prognosis.
本文呈现了一项针对62例患者、共69处颅外颈内动脉夹层的研究结果。诊断时的平均年龄为43岁，男性多于女性。患者平均随访时间为41个月。在6例被认为起源于“创伤性”的病例中，其结果与“自发性”夹层相似。最显著的相关因素似乎是偏头痛（34%）、正在接受雌激素和孕激素治疗（48%的女性）以及纤维肌发育异常（21%）。临床特征包括局部体征（8例单独出现）、缺血体征（9例单独出现）或两者皆有。出现了35例确诊的脑血管意外以及2例导致失明的缺血性视神经炎，31%的患者出现了致残后遗症。最常见的局部体征为偏侧头痛、颈部疼痛、霍纳综合征和耳鸣。初次血管造影显示，四分之一的病例出现闭塞，70%出现狭窄。狭窄通常位于动脉的岩下第二半段，血管造影预后最为良好。
