Department of Emergency Medicine, Universitair Ziekenhuis Brussel, Brussels, Belgium.
Eur J Emerg Med. 2012 Jun;19(3):181-7. doi: 10.1097/MEJ.0b013e328349ee6d.
Carotid artery dissections are potentially disabling, probably underdiagnosed, and mainly affect young-aged and middle-aged people. We present three consecutive cases illustrating different clinical presentations and thereby emphasizing the diagnostic challenge of carotid artery dissections for the emergency physician. Neck and facial pain, headache, unilateral pulsatile tinnitus, partial Horner's syndrome (or oculosympathetic palsy), amaurosis fugax, retinal infarction, and anterior circulation brain ischemia may all occur in isolation or in various combinations. Medical imaging plays a pivotal role in making the right diagnosis. Clinical vigilance is of utmost importance as early diagnosis and timely treatment favor long-term prognosis and even prevent ischemic complications. We review the literature and discuss the pathophysiology, etiology, clinical presentation, diagnosis, imaging techniques, treatment, and prognosis of carotid dissections.
颈动脉夹层可能导致残疾，可能诊断不足，主要影响年轻和中年人群。我们呈现三个连续的病例，说明了不同的临床表现，从而强调了颈动脉夹层对急诊医师的诊断挑战。颈部和面部疼痛、头痛、单侧搏动性耳鸣、部分霍纳氏综合征（或交感性眼肌麻痹）、一过性黑矇、视网膜梗死和前循环脑缺血都可能单独或组合出现。医学影像学在做出正确诊断方面起着关键作用。临床警惕性至关重要，因为早期诊断和及时治疗有利于长期预后，甚至可以预防缺血性并发症。我们回顾了文献，讨论了颈动脉夹层的病理生理学、病因、临床表现、诊断、影像学技术、治疗和预后。
