Cadena Rhonda, Kim Jeremy
Assistant Professor, Departments of Neurology, Neurosurgery, and Emergency Medicine, University of North Carolina, Chapel Hill, NC.
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Emerg Med Pract. 2016 Jul 22;18(7 Suppl Points & Pearls):S1-S2.
Cervical artery dissections involve the carotid or vertebral arteries. Although the overall incidence is low, they remain a common cause of stroke in children, young adults, and trauma patients. Symptoms such as headache, neck pain, and dizziness are commonly seen in the emergency department, but may not be apparent in the obtunded trauma patient. A missed diagnosis of cervical artery dissection can result in devastating neurological sequelae, so emergency clinicians must act quickly to recognize this event and begin treatment as soon as possible while neurological consultation is obtained. This issue reviews the evidence in applying advanced screening criteria and choosing imaging and antithrombotic treatment strategies for patients with cervical artery dissections to reduce the occurrence of ischemic stroke. [Points & Pearls is a digest of Emergency Medicine Practice].
颈动脉夹层累及颈内动脉或椎动脉。尽管总体发病率较低,但它们仍是儿童、青年人和创伤患者中风的常见原因。头痛、颈部疼痛和头晕等症状在急诊科很常见,但在意识不清的创伤患者中可能不明显。颈动脉夹层漏诊可导致严重的神经后遗症,因此急诊临床医生必须迅速行动,识别这一情况,并在获得神经科会诊的同时尽快开始治疗。本期对应用高级筛查标准以及为颈动脉夹层患者选择影像学和抗栓治疗策略以减少缺血性中风发生的证据进行了综述。[要点与精华是《急诊医学实践》的摘要]