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[一例青年成人脑梗死,因颈椎旋转反复接触刺激伴寰枢椎半脱位、寰椎发育异常等全身畸形导致椎动脉血栓形成性闭塞]

[A case of cerebral infarction in young adult resulting in thrombotic occlusion of vertebral artery due to repeated contact stimulation of cervical rotation accompanied to systemic malformations such as atlantoaxial subluxation and atlas dysplasia].

作者信息

Taniguchi Yoko, Kitamura Taro, Muto Masahiro, Miura Toshiyasu, Yamada Kentaro

机构信息

Department of Neurology, Nagoya City East Medical Center.

Department of Radiology, Nagoya City East Medical Center.

出版信息

Rinsho Shinkeigaku. 2020 Sep 29;60(9):609-613. doi: 10.5692/clinicalneurol.cn-001430. Epub 2020 Aug 8.

Abstract

A 23-year-old man admitted to our hospital with headache and dysarthria. Head MRI showed multiple acute cerebral infarctions in the right posterior circulation. Atlantoaxial dislocation, atlas dysplasia and thrombotic occlusion of right vertebral artery (VA), and blood flow disruption due to cervical rotation was observed. The axial dental process bordered to the right VA, and repeated contact stimulation by cervical rotation may cause intimal damage resulting in thrombotic occlusion. In this case, various systemic malformations such as atrial septal defect, atlas posterior arch hypoplasia, bovine left common carotid bifurcation malformation, double inferior vena cava and horseshoe kidney may have been congenital syndromes. Atlantoaxial dislocation may be an important and under-recognized cause of stroke in young adults.

摘要

一名23岁男性因头痛和构音障碍入院。头部磁共振成像(MRI)显示右侧后循环多发急性脑梗死。观察到寰枢椎脱位、寰椎发育异常及右侧椎动脉(VA)血栓形成性闭塞,以及颈部旋转导致的血流中断。齿突轴向毗邻右侧椎动脉,颈部旋转反复的接触刺激可能导致内膜损伤,进而造成血栓形成性闭塞。在该病例中,诸如房间隔缺损、寰椎后弓发育不全、左侧颈总动脉分叉处牛型畸形、双下腔静脉及马蹄肾等各种全身畸形可能属于先天性综合征。寰枢椎脱位可能是年轻成年人卒中的一个重要且未被充分认识的病因。

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