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茎突源性颈椎病致颈内静脉受压,一种与多种临床神经学表现相关的血管疾病:诊断与治疗——一项全面的文献综述

Styloidogenic-cervical spondylotic internal jugular venous compression, a vascular disease related to several clinical neurological manifestations: diagnosis and treatment-a comprehensive literature review.

作者信息

Scerrati Alba, Norri Nicoló, Mongardi Lorenzo, Dones Flavia, Ricciardi Luca, Trevisi Gianluca, Menegatti Erica, Zamboni Paolo, Cavallo Michele Alessandro, De Bonis Pasquale

机构信息

Neurosurgery Department, Sant'Anna University Hospital, Ferrara, Italy.

Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy.

出版信息

Ann Transl Med. 2021 Apr;9(8):718. doi: 10.21037/atm-20-7698.

Abstract

Internal jugular vein (IJV) stenosis is associated with several central nervous system disorders such as Ménière or Alzheimer's disease. The extrinsic compression between the styloid process and the C1 transverse process, is an emerging biomarker related to several clinical manifestations. However, nowadays a limited number of cases are reported, and few information are available about treatment, outcome and complications. Our aim is to collect and identify clinical-radiological characteristics, diagnosis and treatment of the styloidogenic internal jugular venous compression. We performed a comprehensive literature review. Studies reporting patients suffering from extracranial jugular stenosis were searched. For every patient we collected: demography, clinical and radiological characteristics and outcome, type of treatment, complications. Thirteen articles reporting 149 patients were included. Clinical presentation was non-specific. Most frequent symptoms were headache (46.3%), tinnitus (43.6%), insomnia (39.6%). The stenosis was monolateral in 51 patients (45.9%) and bilateral in 60 (54.1%). Anticoagulants were the most common prescribed drug (57.4%). Endovascular treatment was performed in 50 patients (33.6%), surgery in 55 (36.9%), combined in 28 (18.8%). Improvement of general conditions was reported in 58/80 patients (72.5%). Complications were reported in 23% of cases. Jugular stenosis is a complex and often underestimated disease. Conservative medical treatment usually fails while surgical, endovascular or a combined treatment improves general conditions in more than 70% of patients.

摘要

颈内静脉(IJV)狭窄与多种中枢神经系统疾病相关,如梅尼埃病或阿尔茨海默病。茎突与C1横突之间的外部压迫是一种与多种临床表现相关的新兴生物标志物。然而,目前报道的病例数量有限,关于治疗、预后和并发症的信息也很少。我们的目的是收集并确定茎突源性颈内静脉压迫的临床放射学特征、诊断和治疗方法。我们进行了全面的文献综述。检索了报告颅外颈静脉狭窄患者的研究。对于每一位患者,我们收集了:人口统计学、临床和放射学特征及预后、治疗类型、并发症。纳入了13篇报告149例患者的文章。临床表现不具有特异性。最常见的症状是头痛(46.3%)、耳鸣(43.6%)、失眠(39.6%)。51例患者(45.9%)为单侧狭窄,60例(54.1%)为双侧狭窄。抗凝剂是最常用的处方药(57.4%)。50例患者(33.6%)接受了血管内治疗,55例(36.9%)接受了手术治疗,28例(18.8%)接受了联合治疗。80例患者中有58例(72.5%)报告总体状况有所改善。23%的病例报告有并发症。颈静脉狭窄是一种复杂且常被低估的疾病。保守药物治疗通常无效,而手术、血管内或联合治疗能使70%以上的患者总体状况得到改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb61/8106058/8b04f5213e77/atm-09-08-718-f1.jpg

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