Verdin V, Holemans C, Otto B, Van Damme H, Defraigne J O
Service de Neuro-Radiologie, CHU de Liège, Belgique.
Rev Med Liege. 2013 Jan;68(1):11-5.
We report a case of spontaneous carotid artery dissection suspected by the appearance of Horner's syndrome. Under medical treatment, the intramural hematoma resolved within 3 months. The patient had an uneventful recovery, without any residual neurologic deficit. Spontaneous arterial dissection is responsible for a hematoma in the arterial wall without significant trauma. The pathogenesis remains unknown. Predisposing factors seem to exist. The clinical presentation is variable mainly due to local compression of adjacent structures which can precede a transient or permanent neurological deficit. The diagnosis is confirmed by Doppler US, CT angiography or magnetic resonance angiography, the best optional investigations. The treatment mainly consists of stroke prevention by anticoagulation versus antiplatelet therapy. The role of surgery and/or endovascular techniques has not yet been confirmed.
我们报告一例因霍纳综合征表现而疑似自发性颈动脉夹层的病例。在药物治疗下，壁内血肿在3个月内消退。患者恢复顺利，无任何残留神经功能缺损。自发性动脉夹层可导致动脉壁内血肿，而无明显创伤。其发病机制尚不清楚。似乎存在诱发因素。临床表现多样，主要是由于对相邻结构的局部压迫，这可能先于短暂或永久性神经功能缺损出现。通过多普勒超声、CT血管造影或磁共振血管造影可确诊，这些是最佳的可选检查方法。治疗主要包括通过抗凝与抗血小板治疗预防中风。手术和/或血管内技术的作用尚未得到证实。
