Ouyang Zhi-Yuan, Qiu Min-Jian, Zhao Zhe, Wu Xiao-Bing, Tong Lu-Sha
The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
Department of Orthopedics, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China.
BMJ Case Rep. 2017 Jan 4;2017:bcr2016012731. doi: 10.1136/bcr-2016-012731.
We report an extremely rare case involving a posterior arch anomaly of the atlas, causing a vertebral artery dissection (VAD) induced posterior circulation stroke. A 16-year-old girl was admitted to hospital because of new onset dizziness. VAD related multiple infarction in the posterior circulation was revealed. The congenital posterior arch anomaly of the atlas, along with instability of the atlantoaxial joint, were discovered accidentally during follow-up. This is the first case of ischemic stroke related to atlantal posterior arch aplasia and atlantoaxial instability. Although rare, it reminds us that investigation of the craniovertebral junction should be considered when stroke occurs in young patients.
我们报告了一例极其罕见的病例，该病例涉及寰椎后弓异常，导致椎动脉夹层（VAD）引发后循环卒中。一名16岁女孩因新发头晕入院。检查发现VAD相关的后循环多处梗死。在随访过程中意外发现了先天性寰椎后弓异常以及寰枢关节不稳。这是首例与寰椎后弓发育不全和寰枢关节不稳相关的缺血性卒中病例。尽管罕见，但它提醒我们，当年轻患者发生卒中时，应考虑对颅颈交界区进行检查。
