Kumar S D, Kumar V, Kaye W
Department of Surgery and Medicine, Brown University-The Miriam Hospital, Providence, RI 02906, USA.
Am J Emerg Med. 1998 Nov;16(7):669-70. doi: 10.1016/s0735-6757(98)90172-3.
Dissection of the internal carotid artery is responsible for approximately 5% of ischemic strokes in adults. The pathophysiology of dissection can be either traumatic or spontaneous. The true incidence of spontaneous dissection is unknown. Once considered very rare, an increased awareness, combined with noninvasive evaluation by ultrasound and magnetic resonance angiography, has demonstrated a more frequent occurrence. Trivial trauma (ie, rather than external blunt or penetrating trauma) such as vomiting has rarely been documented as causing bilateral dissection. It is well recognized by neurologists but often not by other physicians. Prognosis is good, but delay in diagnosis may result in residual neurologic deficits. It should therefore be suspected early, especially in younger patients presenting with transient ischemic attacks or stroke.
颈内动脉夹层是成人缺血性卒中的约5%的病因。夹层的病理生理学可以是创伤性的或自发性的。自发性夹层的真实发病率尚不清楚。曾经被认为非常罕见，随着认识的提高，结合超声和磁共振血管造影的无创评估，已显示其发生更为频繁。轻微创伤（即而非外部钝性或穿透性创伤）如呕吐很少被记录为导致双侧夹层。神经科医生对此有充分认识，但其他医生往往不了解。预后良好，但诊断延迟可能导致残留神经功能缺损。因此应尽早怀疑，尤其是在出现短暂性脑缺血发作或卒中的年轻患者中。
