Barbour P J, Castaldo J E, Rae-Grant A D, Gee W, Reed J F, Jenny D, Longennecker J
Department of Medicine, Lehigh Valley Hospital, Allentown, Pa.
Stroke. 1994 Jun;25(6):1201-6. doi: 10.1161/01.str.25.6.1201.
Redundant internal carotid arteries have been considered a risk factor in tonsillectomy, adenoidectomy, and surgical treatment of peritonsillar abscess and also a potentially treatable cause of stroke. However, an association between internal carotid artery redundancy and spontaneous dissection has not yet been clearly demonstrated.
We reviewed, for spontaneous carotid artery dissection, records of all patients admitted to our institution during the period from 1986 through 1992 with the diagnosis of stroke or transient ischemic attack. We also reviewed 108 percutaneous cerebral arteriograms performed between September 1992 and December 1992 for presence of carotid artery redundancies.
Thirteen patients exhibited spontaneous dissection. Of these, 8 of 13 (62%) patients and 13 of 20 (65%) internal carotid arteries, viewed to the siphon, had significant redundancies, kinks, coils, or loops. Of 108 consecutive arteriograms of patients without dissection, in which 187 internal carotid arteries were viewed to the siphon, there were 20 (19%) patients and 22 (12%) of 187 vessels with significant redundancy. Five patients in the dissection group and 2 in the nondissection group had bilateral internal carotid artery redundancy (P = .0019 and P = .0001, respectively).
We found a significant correlation between internal carotid artery redundancy and dissection, particularly if redundancy is present bilaterally.
颈内动脉冗长迂曲被认为是扁桃体切除术、腺样体切除术及扁桃体周围脓肿手术治疗的危险因素，也是卒中的一个潜在可治疗病因。然而，颈内动脉冗长迂曲与自发性夹层形成之间的关联尚未得到明确证实。
我们回顾了1986年至1992年期间我院收治的所有诊断为卒中或短暂性脑缺血发作患者的自发性颈动脉夹层形成记录。我们还回顾了1992年9月至1992年12月期间进行的108例经皮脑血管造影，以检查是否存在颈动脉冗长迂曲情况。
13例患者出现自发性夹层形成。其中，13例患者中的8例（62%）以及20条颈内动脉中的13条（65%），在观察虹吸部时存在明显的冗长迂曲、扭结、盘绕或袢状改变。在108例无夹层形成患者的连续血管造影中，观察虹吸部的187条颈内动脉中，有20例患者（19%）以及187条血管中的22条（12%）存在明显的冗长迂曲。夹层形成组有5例患者、非夹层形成组有2例患者存在双侧颈内动脉冗长迂曲（P值分别为0.0019和0.0001）。
我们发现颈内动脉冗长迂曲与夹层形成之间存在显著相关性，尤其是双侧存在冗长迂曲时。
