Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Radiology, Neurosurgery, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
J Neurointerv Surg. 2024 Aug 14;16(9):939-946. doi: 10.1136/jnis-2022-019577.
Mechanical disorders of the cervicocerebral circulation (MDCC) are conditions in which neurological symptoms result from a disturbance of cerebral blood flow attributable to external mechanical forces exerted on extracranial blood vessels by adjacent musculoskeletal structures during head movement that is presumably within a physiological range. The disease spectrum includes bow hunter's syndrome, carotid-type Eagle syndrome, and various dynamic venous compression syndromes. These conditions have distinct phenotypes in children which differ from those expressed in older adults. In contemporary practice, recognition and diagnostic evaluation is the domain of the neuroendovascular specialist. The diagnostic evaluation of MDCC involves significant technical nuance that can be critical to directing appropriate management, particularly in children. This report aims to provide a comprehensive overview of the pathophysiology, anatomical patterns, diagnosis, and treatment for the full spectrum of MDCC that is commonly encountered in clinical practice.
颈脑循环机械障碍(MDCC)是指由于头动时邻近肌肉骨骼结构对颅外血管施加的外部机械力导致脑血流紊乱而引起的神经系统症状,这种头动通常在生理范围内。该疾病谱包括猎弓手综合征、颈动脉型鹰钩综合征和各种动态静脉压迫综合征。这些病症在儿童中的表现与在老年人中的表现不同,具有明显的表型差异。在当代实践中,神经血管专科医生负责识别和诊断评估。MDCC 的诊断评估涉及到重要的技术细节,这些细节对于指导适当的治疗至关重要,尤其是在儿童中。本报告旨在全面概述 MDCC 的病理生理学、解剖模式、诊断和治疗,这些内容在临床实践中很常见。