Kan Peter, Srivatsan Aditya, Johnnson Jeremiah N, Chen Stephen R
Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
Department of Radiology, Baylor College of Medicine, Houston, Texas, USA.
BMJ Case Rep. 2018 Oct 14;2018:bcr-2018-014210. doi: 10.1136/bcr-2018-014210.
We report an unusual case in which physiologic neck rotation impeded perfusion through the internal carotid artery. The patient had a history of prior radical neck surgery and radiation for malignancy. He presented withbow hunter's-like symptoms with transient loss of consciousness and right-sided weakness with left lateral neck rotation. A self-expanding peripheral stent was successfully used to treat the patient by preventing rotatory carotid compression. In select patients with prior neck surgery and radiation, carotid injections should be part of a dynamic cerebral angiogram if the vertebral arteries are unremarkable.
我们报告了一例罕见病例，生理性颈部旋转阻碍了颈内动脉的血流灌注。该患者有颈部恶性肿瘤根治性手术及放疗史。他出现类似“低头猎人”的症状，即向左颈部旋转时短暂意识丧失和右侧肢体无力。通过使用自膨式外周支架预防旋转性颈动脉受压，成功治疗了该患者。对于有颈部手术及放疗史的特定患者，如果椎动脉无异常，颈动脉注射应作为动态脑血管造影的一部分。
