Department of Neurology, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.
J Spinal Cord Med. 2020 Jan;43(1):130-133. doi: 10.1080/10790268.2017.1422880. Epub 2018 Jan 11.
Cervical spinal cord infarction is a rare and severe complication of vertebral artery dissection (VAD). We report a case of VAD in an acute stage followed by cervical spinal cord infarction that was treated using direct endovascular tirofiban infusion via digital subtraction angiography (DSA) monitoring. A 48-year-old man presented with vertigo, neck pain, numbness and weakness in four limbs with subsequent cardiac and respiratory arrest. Neurological examination revealed hypoesthesia below the neck with grade one myodynamia on the right side of the limbs and zero on the left side. The diagnosis of VAD-related cervical spinal infarction was confirmed using DSA imaging and cervical vertebra magnetic resonance imaging (MRI). The patient received timely treatment with endovascular tirofiban infusion and achieved good outcome without any sequelae. Endovascular treatment with tirofiban may be a selective choice for cervical spinal cord infarction due to VAD in acute stage and warrants further study.
颈脊髓梗死是椎动脉夹层（VAD）的一种罕见且严重的并发症。我们报告了一例急性 VAD 后继发颈脊髓梗死的病例，该病例通过数字减影血管造影（DSA）监测行直接血管内替罗非班输注治疗。一名 48 岁男性因眩晕、颈部疼痛、四肢麻木和无力，随后出现心脏和呼吸骤停而就诊。神经学检查显示颈部以下感觉减退，四肢右侧肌力 1 级，左侧 0 级。DSA 成像和颈椎磁共振成像（MRI）证实了与 VAD 相关的颈脊髓梗死的诊断。该患者及时接受了血管内替罗非班输注治疗，结果良好，无任何后遗症。对于急性颈脊髓梗死由于 VAD 引起的病例，血管内治疗用替罗非班可能是一种选择性选择，需要进一步研究。
