Department of Neurology, Infermi Hospital, Viale Luigi Settembrini, Rimini, Italy.
Neurol Sci. 2020 Dec;41(Suppl 2):395-399. doi: 10.1007/s10072-020-04651-8.
Cervicocerebral artery dissection (CAD) is one of the more frequent causes of stroke in young adults with rates of up to 25%. Predisposing and risk factors for CAD are very different, and an etiological classification is based on the presence of a previous minor or major trauma, differentiating traumatic from spontaneous CAD. Headache represents one of the main initial symptoms for this pathological condition, probably due to the release of pro-inflammatory neurotransmitters from nerve terminals near the injured vessel. For its peculiar characteristics, the headache due to CAD has been defined with specific ICHD-3 criteria. In many cases, headache is associated with other signs related to the dissection or cerebral ischemia. In this systematic review of literature, headache was reported in more than 70% of cases with CAD with a prevalence in vertebrobasilar dissections. More than half of patients suffered a severe pain that was usually located in fronto-temporal and occipito-nuchal regions in the case of dissections in the anterior and posterior circulation, respectively. For the high stroke risk, CAD has to be promptly diagnosed with MRI or CTA and treated with anticoagulants or antithrombotics.
颈内动脉夹层（CAD）是导致年轻成年人中风的常见原因之一，其发病率高达 25%。CAD 的诱发因素和风险因素非常不同，病因分类基于先前存在的轻微或重大创伤，将创伤性和自发性 CAD 区分开来。头痛是这种病理状况的主要初始症状之一，可能是由于损伤血管附近的神经末梢释放促炎神经递质所致。由于其特殊的特征，CAD 引起的头痛已根据 ICHD-3 标准进行了定义。在许多情况下，头痛与其他与夹层或脑缺血相关的体征有关。在对文献的系统回顾中，超过 70%的 CAD 患者报告有头痛，其中椎动脉夹层的发病率更高。超过一半的患者遭受剧烈疼痛，在前循环和后循环夹层的情况下，疼痛通常分别位于额颞部和枕颈部。由于发生中风的风险较高，因此必须通过 MRI 或 CTA 及时诊断 CAD，并使用抗凝剂或抗血栓药物进行治疗。
