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使用蹦床后椎动脉夹层导致中风

Vertebral Artery Dissection Causing Stroke After Trampoline Use.

作者信息

Casserly Courtney S, Lim Rodrick K, Prasad Asuri Narayan

机构信息

From the *University of Western Ontario; and †Children's Hospital at London Health Sciences Centre, Western University, London, Ontario, Canada.

出版信息

Pediatr Emerg Care. 2015 Nov;31(11):771-3. doi: 10.1097/PEC.0000000000000388.

Abstract

OBJECTIVES

The aim of this study was to report a case of a 4-year-old boy who had been playing on the trampoline and presented to the emergency department (ED) with vomiting and ataxia, and had a vertebral artery dissection with subsequent posterior circulation infarcts.

METHODS

This study is a chart review.

RESULTS

The patient presented to the emergency department with a 4-day history of vomiting and gait unsteadiness. A computed tomography scan of his head revealed multiple left cerebellar infarcts. Subsequent magnetic resonance imaging/magnetic resonance angiogram of his head and neck demonstrated multiple infarcts involving the left cerebellum, bilateral thalami, and left occipital lobe. A computed tomography angiogram confirmed the presence of a left vertebral artery dissection.

CONCLUSIONS

Vertebral artery dissection is a relatively common cause of stroke in the pediatric age group. Trampoline use has been associated with significant risk of injury to the head and neck. Patients who are small and/or young are most at risk. In this case, minor trauma secondary to trampoline use could be a possible mechanism for vertebral artery dissection and subsequent strokes. The association in this case warrants careful consideration because trampoline use could pose a significant risk to pediatric users.

摘要

目的

本研究旨在报告一例4岁男孩的病例,该男孩在蹦床上玩耍后出现呕吐和共济失调症状,并因椎动脉夹层形成继发后循环梗死而被送至急诊科。

方法

本研究为病例回顾。

结果

该患者因呕吐和步态不稳4天就诊于急诊科。其头部计算机断层扫描显示左小脑多处梗死。随后对其头部和颈部进行的磁共振成像/磁共振血管造影显示,左小脑、双侧丘脑和左枕叶多处梗死。计算机断层血管造影证实存在左椎动脉夹层。

结论

椎动脉夹层是儿童年龄组中风的相对常见原因。使用蹦床与头部和颈部受伤的重大风险相关。年龄小和/或身材小的患者风险最高。在本病例中,蹦床使用继发的轻微创伤可能是椎动脉夹层形成及随后中风的一种可能机制。鉴于蹦床使用可能给儿童使用者带来重大风险,本病例中的关联值得仔细考虑。

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