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采用手术夹闭V3段预防与颅外椎动脉夹层相关的复发性脑梗死：一例报告

Surgical clip occlusion of the V3 segment to prevent recurrent cerebral infarction associated with extracranial vertebral artery dissection: A case report.

作者信息

Aiura Ryo, Matsumoto Masaki, Mizutani Tohru, Sugiyama Tatsuya, Tanioka Daisuke

机构信息

Department of Neurosurgery, Showa University Hospital, Tokyo, Shinagawa-ku, Japan.

出版信息

Surg Neurol Int. 2020 Oct 15;11:337. doi: 10.25259/SNI_405_2020. eCollection 2020.

DOI:10.25259/SNI_405_2020
PMID:33194271
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7656025/
Abstract

BACKGROUND

Recurrent cerebral infarction caused by traumatic extracranial vertebral artery dissection (EVAD) is treated medically and surgically. We report a case of EVAD that was treated using surgical clip occlusion of the V3 segment to prevent recurrent cerebral infarction.

CASE DESCRIPTION

A 48-year-old man was admitted for a cerebral infarction caused by EVAD and was treated using 200 mg/day cilostazol. Afterward, the cerebral infarction recurred. Digital subtraction angiography revealed that initial severe stenosis of the VA ostium resulted in the final occlusion and that collateral vessels to the VA remained. We continued antiplatelet therapy, but the cerebral infarction recurred due to thromboembolism of the collateral vessels. Parent artery occlusion was planned. We exposed the V3 segment of the VA and clipped it to prevent the recurrence of cerebral infarction.

CONCLUSION

Surgical clip occlusion of the V3 segment was effective for treating recurrent cerebral infarction caused by traumatic EVAD that had remained an issue despite continuing medical therapy.

摘要

背景

创伤性颅外椎动脉夹层（EVAD）所致复发性脑梗死可采用内科和外科治疗。我们报告1例采用手术夹闭V3段治疗EVAD以预防复发性脑梗死的病例。

病例描述

一名48岁男性因EVAD导致脑梗死入院，接受西洛他唑200mg/天治疗。此后，脑梗死复发。数字减影血管造影显示，椎动脉起始部最初的严重狭窄导致最终闭塞，且椎动脉的侧支血管仍然存在。我们继续进行抗血小板治疗，但由于侧支血管血栓栓塞，脑梗死复发。遂计划行供血动脉闭塞术。我们暴露椎动脉V3段并进行夹闭以预防脑梗死复发。

结论

手术夹闭V3段对于治疗创伤性EVAD所致复发性脑梗死有效，尽管持续内科治疗，该问题仍然存在。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8401/7656025/0eaacb58edb8/SNI-11-337-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8401/7656025/2653f52b816c/SNI-11-337-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8401/7656025/dc5cb3a79ab4/SNI-11-337-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8401/7656025/7308a1b4488a/SNI-11-337-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8401/7656025/2eee5b85faf2/SNI-11-337-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8401/7656025/ca569dd3c38c/SNI-11-337-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8401/7656025/0eaacb58edb8/SNI-11-337-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8401/7656025/2653f52b816c/SNI-11-337-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8401/7656025/dc5cb3a79ab4/SNI-11-337-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8401/7656025/7308a1b4488a/SNI-11-337-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8401/7656025/2eee5b85faf2/SNI-11-337-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8401/7656025/ca569dd3c38c/SNI-11-337-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8401/7656025/0eaacb58edb8/SNI-11-337-g006.jpg

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