Sawa Nobufusa Nobuhiro, Kataoka Hiroshi, Ueno Satoshi
Department of Neurology, Nara Medical University, Kashihara, Japan.
BMJ Case Rep. 2013 Jun 7;2013:bcr2013009767. doi: 10.1136/bcr-2013-009767.
We describe a woman with bilateral extracranial internal carotid artery (ICA) vasospasm. Initial MRI of the brain showed multiple areas of high-signal intensity in the white matter of both the frontoparietal lobes. She was alert, and the muscle strength of the four extremities was moderately decreased. Cranial CT on day 3 showed increased numbers of low-density areas in both the anterior cerebral arteries (ACA) and middle cerebral arteries (MCA), accompanied by neurological deterioration. Cranial and cervical CT angiography on day 9 showed that all areas of both the ACA and MCA had become low density. Both ICAs were markedly narrowed along their entire length and tapered. On day 16, the patient died. Three patients with bilateral extracranial ICA spasms have been described previously. To our knowledge, this is the first time to document bilateral ICA spasm causing elongated narrowing of the carotid arteries, leading to an unfortunate outcome.
我们描述了一位患有双侧颅外颈内动脉（ICA）血管痉挛的女性。脑部初始MRI显示双侧额顶叶白质有多个高信号强度区域。她神志清醒，四肢肌力中度下降。第3天的头颅CT显示双侧大脑前动脉（ACA）和大脑中动脉（MCA）的低密度区域数量增加，并伴有神经功能恶化。第9天的头颅和颈部CT血管造影显示，ACA和MCA的所有区域均变为低密度。双侧ICA在其全长均明显变窄并呈锥形。第16天，患者死亡。此前已描述过3例双侧颅外ICA痉挛患者。据我们所知，这是首次记录到双侧ICA痉挛导致颈动脉延长变窄并导致不幸结局。
