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小儿轻微创伤后孤立性颈部疼痛提示颈总动脉夹层:首例儿科病例报告及文献复习

Isolated Cervical Pain Revealing a Common Carotid Artery Dissection in a Child Following a Minor Trauma: A First Pediatric Case Report and a Review of the Literature.

作者信息

Messelmani Mariem, Akkari Manel, Souissi Wala, Mrissa Ridha

机构信息

Department of Neurology, Military Hospital of Tunis, Monfleury, Tunis, Tunisia.

出版信息

Neurol India. 2021 Mar-Apr;69(2):478-479. doi: 10.4103/0028-3886.314524.

Abstract

BACKGROUND

Cervical artery dissections are not exceptional in the pediatric population. Typically, it affects the internal carotid artery or the vertebral artery. To our knowledge, this is the first case of common carotid artery (CCA) dissection in a child.

CASE

We present a case of a 7-year-old-boy admitted to our neurology department complaining of cervical pain after a minor neck trauma. The neurological examination was normal. The ultrasound showed a mural hematoma with an intimal flap. The magnetic resonance angiography revealed an irregular segment of the left CCA just before its bifurcation. The diagnosis of an acute dissection on the left CCA was confirmed and antiplatelet therapy was started.

CONCLUSION

The diagnosis of cervical artery dissections remains a challenge because of its variable clinical presentation. It should be suspected in the context of neck trauma and treatment should be initiated rapidly to reduce the risk of ischemic stroke.

摘要

背景

颈动脉夹层在儿科人群中并不罕见。通常,它会影响颈内动脉或椎动脉。据我们所知,这是首例儿童颈总动脉(CCA)夹层病例。

病例

我们报告一例7岁男孩,因轻微颈部外伤后颈部疼痛入住我院神经科。神经系统检查正常。超声显示有壁内血肿及内膜瓣。磁共振血管造影显示左颈总动脉在分叉前有一段不规则区域。左颈总动脉急性夹层的诊断得到证实,并开始了抗血小板治疗。

结论

由于颈动脉夹层临床表现多样,其诊断仍然是一项挑战。在颈部外伤的情况下应怀疑此病,并且应迅速开始治疗以降低缺血性卒中的风险。

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