Goldstein L B, Gray L, Hulette C M
Department of Medicine (Neurology), Duke University, Durham, NC.
Stroke. 1995 Mar;26(3):480-3. doi: 10.1161/01.str.26.3.480.
Extracranial carotid artery dissection is a well-recognized cause of ischemic stroke. Recurrent carotid artery dissections are infrequent. Recurrent ipsilateral dissection has only rarely been documented and has not been pathologically verified.
A 33-year-old woman presented with a left parieto-occipital ischemic stroke. Angiography demonstrated a pseudoaneurysm of the extracranial left internal carotid artery. There was no angiographic evidence of an underlying vasculopathy. The pseudoaneurysm was resected, and microscopic examination revealed features most consistent with fibromuscular dysplasia with areas of both chronic and recent dissection.
This case suggests that the frequency of fibromuscular dysplasia as a cause for "idiopathic" spontaneous carotid artery dissection may be higher than previously recognized and that recurrent embolization may occur in the setting of chronic dissection due to redissection of the previously involved vessel.
颅外颈动脉夹层是缺血性卒中的一个公认病因。复发性颈动脉夹层并不常见。同侧复发性夹层仅有极少的文献记载，且未经病理证实。
一名33岁女性出现左侧顶枕部缺血性卒中。血管造影显示左颅外颈内动脉假性动脉瘤。血管造影未发现潜在血管病变的证据。切除假性动脉瘤，显微镜检查发现其特征最符合纤维肌发育异常，伴有慢性和近期夹层区域。
该病例提示，纤维肌发育异常作为“特发性”自发性颈动脉夹层病因的发生率可能高于此前认识到的情况，并且在慢性夹层情况下，由于先前受累血管再次夹层，可能会发生复发性栓塞。
