Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
World Neurosurg. 2022 May;161:147-148. doi: 10.1016/j.wneu.2022.02.111. Epub 2022 Mar 3.
A 32-year-old woman presented with chronically progressive spastic quadriparesis. Detailed clinicoradiological evaluation led to the diagnosis of irreducible atlantoaxial dislocation and basilar invagination, with associated "kissing" carotids and an anomalous right vertebral artery (VA). Both internal carotid arteries had an abnormally tortuous course, "kissing" retropharyngeally at the level of C1-C2. The right VA became intradural at the level of C2-C3, an extremely rare anomaly-C3 segmental artery. Despite the deformed joints and the possibility of injuring the anomalous right VA during C2-C3 instrumentation, a tailored posterior-only approach was used to circumvent the arterial fence created by both vascular anomalies. The patient underwent bilateral C1-C2 joint opening and left C1-C2 joint spacer placement, followed by bilateral occipito-C3-C4 fixation. This is possibly the first reported case of a complex craniovertebral junction anomaly associated with both kissing carotids and a C3 segmental VA.
一位 32 岁女性因慢性进行性痉挛性四肢瘫痪就诊。详细的临床影像学评估导致诊断为不可复位的寰枢椎脱位和颅底凹陷症，伴有“亲吻”颈动脉和异常的右侧椎动脉（VA）。双侧颈内动脉的走行异常迂曲，在 C1-C2 水平“亲吻”咽后。右侧 VA 在 C2-C3 水平进入硬脊膜内，这是一种极其罕见的异常——C3 节段性动脉。尽管关节变形，且在 C2-C3 器械操作过程中可能损伤异常的右侧 VA，但采用了定制的后路手术仅处理由这两种血管异常造成的动脉“栅栏”。患者接受了双侧 C1-C2 关节切开术和左侧 C1-C2 关节间隔物放置术，随后进行双侧枕骨颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈颈内静脉穿刺输液部位疼的问题
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今天吃了布洛芬胶囊，大姨妈推迟了好几天了，在药店买的那种，可是还没有用。该怎么办啊？
