Department of Stroke Medicine, University Hospital Crosshouse, Kilmarnock, UK.
Department of Radiology, University Hospital Crosshouse, Kilmarnock, UK.
Br J Hosp Med (Lond). 2022 Apr 2;83(4):1-11. doi: 10.12968/hmed.2021.0421. Epub 2022 Apr 23.
Cervical artery dissection is a major cause of ischaemic stroke in young adults. The diagnosis can be challenging as some patients may present with seemingly benign symptoms such as a headache, neck pain or dizziness. However, the neurological sequelae of a transient ischaemic attack, vision loss or ischaemic stroke are potentially devastating. All hospital clinicians must be able to recognise this diagnosis and organise timely and appropriate investigations as antithrombotic treatment reduces the risk of stroke recurrence. This article reviews the literature to provide practical information for clinicians to recognise key risk factors and features of history and examination which should raise suspicion of cervical artery dissection. Diagnosis can now be made using the non-invasive, commonly available modalities of computed tomography angiography or magnetic resonance angiography. Timely treatment with antithrombotic agents is recommended to reduce the rate of an ischaemic stroke.
颈动脉夹层是青年缺血性脑卒中的主要原因。由于一些患者可能表现出看似良性的症状,如头痛、颈痛或头晕,因此诊断具有挑战性。然而,短暂性脑缺血发作、视力丧失或缺血性脑卒中的神经后遗症可能是毁灭性的。所有医院临床医生都必须能够识别这种诊断,并及时进行适当的检查,因为抗血栓治疗可降低中风复发的风险。本文综述了文献,为临床医生提供了实用信息,以识别关键的风险因素和病史及检查特征,这些特征应引起对颈动脉夹层的怀疑。现在可以使用计算机断层血管造影或磁共振血管造影等无创、常用的方法进行诊断。推荐使用抗血栓药物进行及时治疗,以降低缺血性脑卒中的发生率。