Mendoza Grimón M D, Aladro Benito Y, Daryanani Daryanani R, Muñoz Fernández C
Sección de Neurología, Hospital Nuestra Señora del Pino, Las Palmas de Gran Canaria.
Neurologia. 1998 Jun-Jul;13(6):299-303.
Dissection of internal carotid artery is an unusual cause of stroke. It generally affects the extracranial portion of the vessel, rarely the intra-cranial portion and exceptionally both sections simultaneously. We present two cases of spontaneous dissection with extra and intra-cranial involvement. Two females, 46 and 36 years old, presented as stroke of the right internal carotid (ICA) associated with headaches and ipsilateral Horner's syndrome. An echo-Doppler was done on the first patient, which turned to be normal, and carotid angiography was done to both patients. The first patient showed a filiform stenosis of the right ICA that ran from the origin to the carotid siphon. The second patient showed a longitudinal stenosis of the right ICA 2 cm from the origin, which ended in an obstruction of the terminal branches. The control angiographs at five and six months respectively, showed partial re-channelling or complete re-channelling. The first case was treated with anti-aggregants and the second with anticoagulants. There were no new episodes in either cases. Dissection of the ICA usually only affects the extracranial portion of the artery, stopping in the petrous portion. We do not know why dissection also affected the intra-cranial section of the artery in these two cases.
颈内动脉夹层是一种不常见的中风病因。它通常影响血管的颅外部分，很少累及颅内部分，极个别情况下会同时累及两个部分。我们报告两例自发性夹层并伴有颅外和颅内受累的病例。两名女性，年龄分别为46岁和36岁，表现为右侧颈内动脉（ICA）中风，伴有头痛和同侧霍纳综合征。对第一名患者进行了超声多普勒检查，结果正常，对两名患者均进行了颈动脉血管造影。第一名患者显示右侧ICA从起始部到颈动脉虹吸部呈丝状狭窄。第二名患者显示右侧ICA距起始部2 cm处有纵向狭窄，最终导致终末分支阻塞。分别在五个月和六个月时进行的对照血管造影显示部分再通或完全再通。第一例用抗血小板药物治疗，第二例用抗凝药物治疗。两例均未出现新的发作。ICA夹层通常仅影响动脉的颅外部分，止于岩骨段。我们不知道这两例中夹层为何也累及了动脉的颅内段。
