Balas P, Ioannou N, Milas P, Klonaris C
Athens University Medical School, Greece.
Int Angiol. 1998 Jun;17(2):125-8.
Spontaneous dissection of the internal carotid artery is rarely submitted to surgery. We report a case successfully operated on with complete restoration of the cerebral blood flow. A 43-year-old male was admitted to our hospital 10 days after an episode of amaurosis fugax of the left eye, left sided headache and paresis of the right arm of a few hours duration. A diagnosis of dissection of the left internal carotid artery was made by duplex and triplex ultrasound examination and was confirmed by cerebral arteriography in contrast to magnetic resonance angiography which was misleading. Due to the slow arterial flow from the right to the left cerebral hemisphere through only the posterior communicating arteries we envisaged the possibility of a cerebral infarction if the dissection were to be extended. For this reason a surgical procedure was performed by excising the dissected segment and inserting a venous graft for the re-establishment of the arterial flow. Surgical treatment of spontaneous internal carotid dissection should be considered very carefully when the clinical and laboratory findings suggest the possibility of an impending stroke.
颈内动脉自发性夹层很少接受手术治疗。我们报告一例成功接受手术且脑血流完全恢复的病例。一名43岁男性在出现持续数小时的左眼黑矇、左侧头痛和右臂轻瘫发作10天后入住我院。通过双功和三功超声检查诊断为左颈内动脉夹层，脑动脉造影证实了这一诊断，而磁共振血管造影结果具有误导性。由于仅通过后交通动脉从右向左脑半球的动脉血流缓慢，我们设想如果夹层扩展可能会发生脑梗死。因此，通过切除夹层段并插入静脉移植物以重建动脉血流进行了手术。当临床和实验室检查结果提示即将发生中风的可能性时，应非常谨慎地考虑对颈内动脉自发性夹层进行手术治疗。
