Panisset M, Eidelman B H
Department of Neurology, University of Pittsburgh, School of Medicine, PA 15261.
Stroke. 1990 Jan;21(1):141-7. doi: 10.1161/01.str.21.1.141.
The traditional presentation of spontaneous internal carotid artery dissection includes ipsilateral hemicranial headache, oculosympathetic paresis, and contralateral focal cerebral ischemic deficits. However, we describe two cases with multiple cranial nerve involvement ipsilateral to the dissection as the principal feature. The first patient, a 36-year-old man, had involvement of the 9th, 10th, 11th, and 12th cranial nerves. The second case was a 53-year-old man with abnormalities of the 5th, 7th, 9th, 10th, and 12th cranial nerves. In both, magnetic resonance imaging revealed a ring-like area of abnormal signal intensity surrounding the carotid artery at the skull base. Carotid angiography was consistent with the suggestion of dissection on the magnetic resonance studies in both cases. The patients recovered without anticoagulation. Internal carotid artery dissection may thus present with multiple cranial nerve palsies, which could be mistaken for an infiltrating tumor of the skull base. Magnetic resonance imaging is useful in identifying the condition.
自发性颈内动脉夹层的传统表现包括同侧半侧头痛、动眼神经交感神经麻痹和对侧局灶性脑缺血性缺损。然而，我们描述了两例以夹层同侧多条颅神经受累为主要特征的病例。第一例患者为一名36岁男性，第9、10、11和12颅神经受累。第二例是一名53岁男性，第5、7、9、10和12颅神经异常。在这两例中，磁共振成像显示颅底颈动脉周围有一个环状异常信号强度区域。颈动脉血管造影与两例磁共振研究中夹层的提示一致。患者未接受抗凝治疗而康复。因此，颈内动脉夹层可能表现为多条颅神经麻痹，这可能被误诊为颅底浸润性肿瘤。磁共振成像有助于识别这种情况。
