Kimura K, Hashimoto Y, Dosaka A, Terasaki T, Uchino M
Department of Cerebrovascular Disease, Kumamoto City Hospital.
Rinsho Shinkeigaku. 1996 Feb;36(2):348-51.
A 61-year-old man was admitted to our hospital because of sudden consciousness disturbance, aphasia and right-side hemiparesis. On admission his blood pressure was 124/74mmHg, and his pulse was a regular rate of 46 beats per minute. Electrocardiogram was normal. Thirty minutes after the onset brain computed tomographic (CT) scan showed no abnormality. Fifty minutes after the onset cervical ultrasound examination with color-coded Doppler demonstrated a subintimal dissection with a false channel of the left common carotid artery. Eighty minutes after the onset thoracic CT scan demonstrated the false lumen in ascending and descending thoracic aortic artery. Cervical CT scan showed a dissection with a false channel of the left common carotid artery. We could diagnose him as cerebral infarction due to thoracic aortic and common carotid artery dissection by means of ultrasound examination within 80 minutes after the onset. He spontaneously and fully recovered three days later. We emphasize the usefulness of noninvasive technique such as cervical ultrasound examination with color-coded Doppler in the diagnosis and follow-up of common carotid artery dissection.
一名61岁男性因突发意识障碍、失语及右侧偏瘫入院。入院时血压为124/74mmHg，脉搏规则，每分钟46次。心电图正常。发病30分钟后脑部计算机断层扫描（CT）未显示异常。发病50分钟后经彩色编码多普勒的颈部超声检查显示左颈总动脉内膜下夹层并伴有假腔。发病80分钟后胸部CT扫描显示升主动脉和降主动脉有假腔。颈部CT扫描显示左颈总动脉夹层并伴有假腔。通过超声检查，我们能够在发病后80分钟内将其诊断为胸主动脉和颈总动脉夹层导致的脑梗死。三天后他自发且完全康复。我们强调诸如经彩色编码多普勒的颈部超声检查等非侵入性技术在颈总动脉夹层诊断及随访中的作用。
