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8例颅外椎动脉夹层

[Eight cases of extracranial vertebral artery dissection].

作者信息

Pego R, Marey J, López-Facal M S, Marín-Sánchez M

机构信息

Servicio de Neurología, Hospital Juan Canalejo, La Coruña.

出版信息

Rev Neurol. 1996 Feb;24(126):172-5.

PMID:8714482
Abstract

We present eight cases of extracranial vertebral artery dissection. One of these had traumatic antecedents at the neck level while undergoing massage treatment. Of the rest, in four cases there was only a history of commonplace traumatism at neck level, consisting of twisting or stretching. Most presented pain at this level both before and during symptoms. Five had symptoms compatible with lateral bulbar infarct, two with cerebral infarct and one at the protuberance level. Angiography showed irregular stenosis of the spine on the affected side in five cases, occlusion in three cases. Nuclear magnetic resonance (NMR) was performed on five, with findings compatible with dissection. Six received anticoagulant treatment and two received platelet antiagregants with good recovery except in one patient who died twelve months later without any indication of the existence of dissection. We also carried out a review of the literature with special emphasis on the etiology of spontaneous cases, on clinical and neuroimaging findings and on treatment.

摘要

我们报告了8例颅外椎动脉夹层。其中1例在接受颈部按摩治疗时有颈部创伤史。其余病例中,4例仅有颈部常见创伤史,包括扭转或拉伸。大多数患者在症状出现前及症状发作时均有该部位疼痛。5例有与延髓外侧梗死相符的症状,2例有脑梗死症状,1例在隆突水平出现症状。血管造影显示,5例患侧脊柱有不规则狭窄,3例有闭塞。对5例患者进行了核磁共振检查,结果与夹层相符。6例接受抗凝治疗,2例接受血小板抗聚集剂治疗,除1例患者12个月后死亡且无夹层存在迹象外,其余患者恢复良好。我们还对文献进行了综述,特别强调了自发性病例的病因、临床和神经影像学表现以及治疗方法。

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