单侧颈动脉夹层导致的严重直立性低血压
Severe Orthostatic Hypotension due to Unilateral Carotid Artery Dissection.
作者信息
Ishii Nobuyuki, Mochizuki Hitoshi, Taniguchi Akitoshi, Shiomi Kazutaka, Nakazato Masamitsu
机构信息
Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, University of Miyazaki , Japan.
出版信息
Neurol Int. 2014 Jun 3;6(2):5352. doi: 10.4081/ni.2014.5352. eCollection 2014 Apr 22.
A 46-year-old woman was admitted to our hospital with mild right-sided hemiparesis and orthostatic hypotension. Magnetic resonance angiography of the neck showed stenosis of the left distal carotid sinus surrounded by intraluminal hyperintensities on both T1-weighted and T2-weighted images, representing a periluminal hematoma secondary to carotid artery dissection. The dissection hyper-extended the carotid artery wall and stimulated baroreceptors in the carotid sinus. The stimulated baroreceptors induced carotid sinus hypersensitivity, which may have been related to her orthostatic hypotension. Post-stroke orthostatic hypotension should prompt consideration of carotid artery dissection.
一名46岁女性因轻度右侧偏瘫和体位性低血压入院。颈部磁共振血管造影显示左颈总动脉远端狭窄，在T1加权和T2加权图像上管腔内均有高信号，提示为颈动脉夹层继发的管周血肿。夹层使颈动脉壁过度伸展，并刺激了颈动脉窦内的压力感受器。受刺激的压力感受器诱发了颈动脉窦过敏，这可能与她的体位性低血压有关。中风后出现体位性低血压应促使考虑颈动脉夹层。
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