Friedman W A, Day A L, Quisling R G, Sypert G W, Rhoton A L
Neurosurgery. 1980 Sep;7(3):207-14. doi: 10.1227/00006123-198009000-00001.
Thirteen cases of cervical carotid dissecting aneurysm have been seen at the University of Florida during the past 3 years. In our experience, two groups of patients with this disease can be distinguished clearly by either clinical or angiographic criteria. One group of cervical carotid dissecting aneurysms is characterized by spontaneous onset, unilaterality, and the absence of pseudoaneurysm formation. These lesions have a strong tendency to resolve with appropriate medical therapy. The other group is characterized by an association with obvious predisposing factors, such as fibromuscular dysplasia, angiography, or trauma. These lesions are often associated with pseudoaneurysms and rarely resolve spontaneously. These two groups of lesions probably represent a spectrum of the same basic disease process. The natural history of patients who survive a cervical carotid dissection is usually one of stability or improvement. A trial of medical therapy (to prevent embolic symptoms) and repeat arteriography are indicated before the consideration of surgical therapy.
在过去3年里，佛罗里达大学共接诊了13例颈内动脉夹层动脉瘤患者。根据我们的经验，通过临床或血管造影标准可明确区分出两组患有这种疾病的患者。一组颈内动脉夹层动脉瘤的特点是自发发病、单侧性且无假性动脉瘤形成。这些病变在适当的药物治疗下有很强的自行消退倾向。另一组的特点是与明显的易感因素有关，如纤维肌发育不良、血管造影或外伤。这些病变常伴有假性动脉瘤，很少能自发消退。这两组病变可能代表了同一基本疾病过程的不同表现。颈内动脉夹层存活患者的自然病程通常是病情稳定或好转。在考虑手术治疗之前，应先进行药物治疗试验（以预防栓塞症状）并重复进行动脉造影。
