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旋转性非优势椎动脉闭塞（RVAO）继发的小脑缺血性卒中：幕上手术后的一种罕见并发症。

Cerebellar Ischemic Stroke Secondary to Rotational Non-Dominant Vertebral Artery Occlusion (RVAO): A Rare Complication Following Supratentorial Surgery.

作者信息

Bono Beatrice C, Riva Marco, Pessina Federico

机构信息

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy.

Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy.

出版信息

Asian J Neurosurg. 2023 Mar 31;18(1):206-209. doi: 10.1055/s-0043-1763527. eCollection 2023 Mar.

DOI:10.1055/s-0043-1763527
PMID:37056908
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10089759/
Abstract

Non-traumatic vertebrobasilar stroke syndrome is rare. Many etiological mechanisms have been described over the years, with the dynamic occlusion of one vertebral artery following head rotation (RVAO) being one of them. We report the case of a patient undergoing surgery for supratentorial metastasis, who postoperatively developed a cerebellar ischemic stroke secondary to RVAO. Postoperative imaging showed a right hypoplastic VA; so, a transient occlusive mechanism was thought to be responsible for the postoperative cerebellar stroke. Although rare, RVAO can occur following head rotation during patient positioning for neurosurgical procedures.

摘要

非创伤性椎基底动脉卒中综合征较为罕见。多年来已描述了许多病因机制，其中一种是头部旋转后一侧椎动脉动态闭塞（RVAO）。我们报告了1例接受幕上转移瘤手术的患者，术后因RVAO继发小脑缺血性卒中。术后影像学检查显示右侧椎动脉发育不全；因此，短暂性闭塞机制被认为是术后小脑卒中的原因。尽管罕见，但在神经外科手术患者体位摆放过程中头部旋转后可能发生RVAO。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ac6/10089759/7837be2943a7/10-1055-s-0043-1763527-i22100015-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ac6/10089759/e9d5e3ade5d6/10-1055-s-0043-1763527-i22100015-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ac6/10089759/b242b5fff3d9/10-1055-s-0043-1763527-i22100015-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ac6/10089759/7837be2943a7/10-1055-s-0043-1763527-i22100015-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ac6/10089759/e9d5e3ade5d6/10-1055-s-0043-1763527-i22100015-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ac6/10089759/b242b5fff3d9/10-1055-s-0043-1763527-i22100015-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ac6/10089759/7837be2943a7/10-1055-s-0043-1763527-i22100015-3.jpg

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本文引用的文献

1
Ischemic Stroke Secondary to Dynamic Vertebral Artery Stenosis: Case Report and Review of the Literature.动态椎动脉狭窄继发缺血性卒中：病例报告及文献综述
Cureus. 2021 Dec 4;13(12):e20167. doi: 10.7759/cureus.20167. eCollection 2021 Dec.
2
Rotational Vertebral Artery Compression : Bow Hunter's Syndrome.旋转性椎动脉压迫：弓猎者综合征。
J Korean Neurosurg Soc. 2013 Sep;54(3):243-5. doi: 10.3340/jkns.2013.54.3.243. Epub 2013 Sep 30.
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An embolic bow hunter's stroke associated with anomaly of cervical spine.
Neurology. 2011 Oct 4;77(14):1403-4. doi: 10.1212/WNL.0b013e31823152f9.
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Artery-to-artery embolism with a mobile mural thrombus due to rotational vertebral artery occlusion.因椎动脉旋转闭塞导致的动脉到动脉栓塞，并伴有活动的壁血栓。
J Neuroimaging. 2010 Jul;20(3):284-6. doi: 10.1111/j.1552-6569.2008.00309.x. Epub 2008 Oct 21.
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The syndrome of mechanical occlusion of the vertebral artery: further observations.椎动脉机械性闭塞综合征：进一步观察
Angiology. 1967 Feb;18(2):106-16. doi: 10.1177/000331976701800205.