Department of Neurosurgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku, Tokyo, Japan.
Neurosurg Rev. 2012 Oct;35(4):615-9; discussion 619-20. doi: 10.1007/s10143-012-0416-z. Epub 2012 Aug 11.
Spontaneous occlusion is a rare manifestation of ruptured vertebral artery dissection (VAD). Its natural history and treatment strategy have yet to be established due to its rarity. Here, we report five lesions involving spontaneous occlusion of VAD after subarachnoid haemorrhage, among which three lesions showed recanalisation. Based on our experience and previous reports, spontaneous occlusion of ruptured VAD can be classified into two groups-one group with occlusion in the acute stage with a high incidence of recanalisation and another group with occlusion in the chronic stage with a relatively low incidence of recanalisation. The underlying mechanism is likely different in each group, and treatment strategies should also be tailored depending on the pathophysiology.
自发性闭塞是椎动脉夹层破裂(VAD)的罕见表现。由于其罕见性,其自然病史和治疗策略尚未确定。在这里,我们报告了 5 例蛛网膜下腔出血后 VAD 自发性闭塞的病变,其中 3 例出现再通。根据我们的经验和以往的报告,破裂的 VAD 的自发性闭塞可分为两组-一组在急性阶段闭塞,再通率高,另一组在慢性阶段闭塞,再通率相对较低。两组的潜在机制可能不同,治疗策略也应根据病理生理学进行调整。