Munro N C, McIntosh S, Lawson J, Morley C A, Sutton R, Kenny R A
Cardiovascular Investigation Unit, Royal Victoria Infirmary, Newcastle-upon-Tyne, London, UK.
J Am Geriatr Soc. 1994 Dec;42(12):1248-51. doi: 10.1111/j.1532-5415.1994.tb06505.x.
To review the incidence of neurological complications occurring after carotid sinus massage performed for diagnostic purposes.
Case review and comparison with previously published work.
Syncope Clinic, Royal Victoria Infirmary, Newcastle-upon-Tyne, and Chelsea and Westminster Hospital, London.
Patients undergoing investigation of dizziness, syncope, or unexplained falls.
Carotid sinus massage performed for 5 seconds in both supine and erect postures, both before and after atropine. Contraindications to carotid sinus massage were the presence of carotid bruits, recent myocardial or cerebral ischemia, or previous ventricular tachyarrhythmias.
Two cases of neurological complications were reported from a total of 500 patients (2000 massage episodes) investigated in one center, giving an incidence of 0.1%. Combining this data with another center performing investigations in a similar fashion, seven neurological complications arose from a total of 5000 massage episodes, an incidence of 0.14%. Reported complications were pyramidal signs in five cases and visual field defects in two. Pyramidal weakness persisted in one case with a pre-existing stroke on the same side, and a visual field loss was permanent in one.
Neurological complications following carotid sinus massage for diagnosis of the carotid sinus syndrome are uncommon and usually transient. Contraindications to carotid sinus massage should be respected and the standardized technique used.
回顾为诊断目的进行颈动脉窦按摩后发生神经并发症的发生率。
病例回顾并与先前发表的研究进行比较。
泰恩河畔纽卡斯尔皇家维多利亚医院晕厥诊所以及伦敦切尔西和威斯敏斯特医院。
正在接受头晕、晕厥或不明原因跌倒检查的患者。
在仰卧位和直立位时均进行5秒钟的颈动脉窦按摩，在使用阿托品前后各进行一次。颈动脉窦按摩的禁忌证包括存在颈动脉杂音、近期心肌或脑缺血，或既往有室性快速心律失常。
在一个中心接受检查的500例患者（共2000次按摩）中报告了2例神经并发症，发生率为0.1%。将该数据与另一个以类似方式进行检查的中心的数据相结合，在总共5000次按摩中出现了7例神经并发症，发生率为0.14%。报告的并发症中，5例有锥体束征，2例有视野缺损。1例既往同侧有中风的患者锥体束无力持续存在，1例视野缺损为永久性。
为诊断颈动脉窦综合征而进行颈动脉窦按摩后发生的神经并发症并不常见，且通常为一过性。应遵守颈动脉窦按摩的禁忌证并采用标准化技术。
