Saito Shoji, Hasegawa Hitoshi, Sato Daisuke, Ando Kazuhiro, Motohashi Kunio, Natsumeda Manabu, Kikuchi Bumpei, Oishi Makoto, Fujii Yukihiko
Department of Neurosurgery, Brain Research Institute, Niigata University.
No Shinkei Geka. 2020 Jun;48(6):527-532. doi: 10.11477/mf.1436204223.
Although blunt carotid artery injury is known as an important cause of ischemic stroke, the role of the endovascular treatment for acute ischemic stroke related to blunt carotid injuries remains unclear. We report the case of a patient with acute ischemic stroke secondary to blunt carotid artery injury who was treated with endovascular revascularization. A 46-year-old man suffered from sudden left-sided hemiparesis a day after a strike from a Japanese fencing staff on his right neck. 3D-CT angiography revealed tandem internal carotid artery occlusions of the cervical and C1 portions. We performed endovascular revascularization with carotid artery stenting and direct aspiration of the thrombus and achieved complete recanalization. The patient recovered almost completely. We conclude that endovascular revascularization should not be withheld from patients with acute ischemic stroke related to blunt carotid injury.
尽管钝性颈动脉损伤被认为是缺血性卒中的重要原因,但血管内治疗在与钝性颈动脉损伤相关的急性缺血性卒中中的作用仍不明确。我们报告了一例继发于钝性颈动脉损伤的急性缺血性卒中患者接受血管内血运重建治疗的病例。一名46岁男性在右颈部被日本击剑棍击打一天后突然出现左侧偏瘫。三维CT血管造影显示颈段和C1段颈内动脉串联闭塞。我们通过颈动脉支架置入和血栓直接抽吸进行了血管内血运重建,并实现了完全再通。患者几乎完全康复。我们得出结论,对于与钝性颈动脉损伤相关的急性缺血性卒中患者,不应拒绝进行血管内血运重建治疗。