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颈动脉内膜切除术后的颈动脉夹层与非动脉瘤性蛛网膜下腔出血

Carotid artery dissection and non-aneurysmal subarachnoid hemorrhage following carotid endarterectomy.

作者信息

Kaoutzani Lydia, Garcia Klepper Alfredo, Rahimi Scott Y

机构信息

Department of Neurosurgery, Wellstar Medical College of Georgia Health, 1120 15 Street, Augusta, GA 30912, United States.

Department of Neurology, Wellstar Medical College of Georgia Health, 1120 15 Street, Augusta, GA 30912, United States.

出版信息

J Surg Case Rep. 2024 May 28;2024(5):rjae331. doi: 10.1093/jscr/rjae331. eCollection 2024 May.

Abstract

Stroke continues to be a major public health issue resulting in high mortality and severe long-term disability. Carotid endarterectomy (CEA) plays an important role in the prevention of ischemic stroke. Complications associated with CEA can be life threatening and prompt recognition is crucial. In this report, we present a patient who presented to the hospital with progressive headache, 2 weeks following CEA. He was neurologically intact and hypertensive. Non-contrast head computed tomography (CT) scan showed convexity subarachnoid hemorrhage (SAH). He was found to have a left internal carotid artery dissection. Patients who present to the hospital following CEA with headache and hypertension benefit from a non-contrast head CT scan. The presence of SAH can be a warning sign of cerebral hyperperfusion syndrome. Carotid artery dissection is also a disease entity that can occur in the post-operative period. Prompt recognition and treatment is crucial for the management of these disease entities.

摘要

中风仍然是一个重大的公共卫生问题,会导致高死亡率和严重的长期残疾。颈动脉内膜切除术(CEA)在预防缺血性中风方面发挥着重要作用。与CEA相关的并发症可能危及生命,及时识别至关重要。在本报告中,我们介绍了一名在CEA术后2周因进行性头痛入院的患者。他神经系统完好,患有高血压。非增强头部计算机断层扫描(CT)显示凸面蛛网膜下腔出血(SAH)。他被发现患有左颈内动脉夹层。CEA术后因头痛和高血压入院的患者可从非增强头部CT扫描中获益。SAH的出现可能是脑过度灌注综合征的警示信号。颈动脉夹层也是一种可能在术后发生的疾病实体。及时识别和治疗对于这些疾病实体的管理至关重要。

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