Andrews B T
Department of Neurological Surgery, San Francisco General Hospital, California.
Neurosurgery. 1989 Jul;25(1):90-2. doi: 10.1097/00006123-198907000-00016.
Ligation of the cervical internal carotid artery resulted in an acute neurological deficit in the dominant hemisphere of a 35-year-old man who suffered a penetrating injury to the neck. Regional cerebral hypoperfusion was suspected because the ischemic symptoms occurred while the patient was fully heparinized. Immediate institution of a barbiturate coma, volume expansion, and placement of a high-flow extracranial-intracranial arterial bypass graft led to rapid recovery of hemispheric function. High-flow extracranial-intracranial bypass grafts appear to be indicated for the treatment of symptomatic cerebral ischemia in selected cases of acute ligation or occlusion of the extracranial carotid artery.
一名35岁男性颈部遭受穿透伤，结扎颈内动脉后，其优势半球出现急性神经功能缺损。由于缺血症状在患者充分肝素化时出现，怀疑存在局部脑灌注不足。立即给予巴比妥类药物昏迷、扩容，并放置高流量颅外-颅内动脉搭桥移植物，半球功能迅速恢复。对于急性结扎或闭塞颅外颈动脉的特定病例，高流量颅外-颅内搭桥移植物似乎适用于治疗有症状的脑缺血。
