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颈动脉夹层:流行病学、病理生理学、治疗及预后综述

Cervical Artery Dissection: A Review of the Epidemiology, Pathophysiology, Treatment, and Outcome.

作者信息

Blum Christina A, Yaghi Shadi

机构信息

University of Pennsylvania Health System, Department of Neurology, Stroke division.

Columbia University Medical Center, Department of Neurology, Stroke division.

出版信息

Arch Neurosci. 2015 Oct;2(4). doi: 10.5812/archneurosci.26670. Epub 2015 Oct 17.

Abstract

CONTEXT

Cervical artery dissection (CAD) is a common cause of stroke in young adults. There is controversy over whether anticoagulation is superior to antiplatelet therapy in preventing stroke in patients with CAD, although meta-analyses to date have not shown any difference between the two treatments.

EVIDENCE ACQUISITION

We performed a PubMed search using each of the keywords: , , , and between January 1, 1990 and July 1 2015. We identified evidence-based peer-reviewed articles, including randomized trials, case series and reports, and retrospective reviews that encompass the epidemiology, clinical manifestations, pathophysiology, treatment, and outcome of cervical artery dissection.

RESULTS

This paper highlights the mechanisms of cervical artery dissection and stroke in patients with dissection as well as the natural history and treatment.

CONCLUSION

Given the relatively rare incidence of this disease, multicenter studies with collaborative effort among stroke centers worldwide should be considered to enroll patients with cervical artery dissection in a randomized trial comparing the two treatments.

摘要

背景

颈动脉夹层(CAD)是年轻成年人中风的常见原因。在CAD患者预防中风方面,抗凝治疗是否优于抗血小板治疗存在争议,尽管迄今为止的荟萃分析尚未显示两种治疗方法之间存在任何差异。

证据获取

我们在1990年1月1日至2015年7月1日期间使用以下关键词在PubMed上进行了搜索:[此处原文缺失关键词内容]。我们确定了基于证据的同行评审文章,包括随机试验、病例系列和报告,以及涵盖颈动脉夹层的流行病学、临床表现、病理生理学、治疗和结果的回顾性综述。

结果

本文重点介绍了颈动脉夹层患者夹层及中风的机制以及自然病史和治疗方法。

结论

鉴于这种疾病的发病率相对较低,应考虑在全球中风中心之间开展多中心合作研究,将颈动脉夹层患者纳入一项比较两种治疗方法的随机试验。

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本文引用的文献

1
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Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): a randomised trial.
Lancet Neurol. 2015 Apr;14(4):361-7. doi: 10.1016/S1474-4422(15)70018-9. Epub 2015 Feb 12.
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Antiplatelets vs anticoagulation for dissection: CADISS nonrandomized arm and meta-analysis.
Neurology. 2012 Aug 14;79(7):686-9. doi: 10.1212/WNL.0b013e318264e36b. Epub 2012 Aug 1.
9
Aspirin versus anticoagulation in intra- and extracranial vertebral artery dissection.
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Mechanism of ischemic infarct in spontaneous cervical artery dissection.
Stroke. 2012 May;43(5):1354-61. doi: 10.1161/STROKEAHA.111.643338. Epub 2012 Mar 8.

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