Department of Neurosurgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8501, Japan.
Department of Clinical Neuroscience and Neurology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8501, Japan.
Medicina (Kaunas). 2022 May 20;58(5):679. doi: 10.3390/medicina58050679.
: Non-cystic manifestation of autosomal dominant polycystic kidney disease (ADPKD) is an important risk factor for cerebral aneurysms. In this report, we describe a rare spontaneous internal carotid artery (ICA) dissection in a patient with ADPKD. A 38-year-old woman with a history of ADPKD and acute myocardial infarction due to coronary artery dissection experienced severe spontaneous pain on the left side of her neck. Magnetic resonance imaging (MRI) revealed a severe left ICA stenosis localized at its origin. Carotid plaque MRI showed that the stenotic lesion was due to a subacute intramural hematoma. Close follow-up by an imaging study was performed under the diagnosis of spontaneous extracranial ICA dissection, and spontaneous regression of the intramural hematoma was observed uneventfully. : When patients with a history of ADPKD present with severe neck pain, it is crucial to consider the possibility of a spontaneous ICA dissection. A carotid plaque MRI is beneficial in the differential diagnosis. Conservative management may benefit patients without ischemic symptoms.
常染色体显性遗传多囊肾病（ADPKD）的非囊性表现是脑动脉瘤的一个重要危险因素。在本报告中，我们描述了一名 ADPKD 患者中罕见的自发性颈内动脉（ICA）夹层。一名 38 岁的女性，有 ADPKD 病史和因冠状动脉夹层导致的急性心肌梗死，曾经历过严重的左侧颈部自发性疼痛。磁共振成像（MRI）显示左侧 ICA 起源处严重狭窄。颈动脉斑块 MRI 显示狭窄病变是由于亚急性壁内血肿。在自发性颅外 ICA 夹层的诊断下进行了密切的影像学随访，壁内血肿自发性消退，无并发症。当有 ADPKD 病史的患者出现严重颈部疼痛时，必须考虑自发性 ICA 夹层的可能性。颈动脉斑块 MRI 有助于鉴别诊断。对于没有缺血症状的患者，保守治疗可能有益。
