Ehrenfeld W K, Wylie E J
Arch Surg. 1976 Nov;111(11):1294-1301. doi: 10.1001/archsurg.1976.01360290128019.
The arteriographic diagnosis of spontaneous, nontraumatic dissection of the internal carotid artery was made in 19 patients and confirmed at operation in ten. The tapered narrowing beginning in or about the carotid bulb and ending at the bony canal was a consistent finding. Four patients had associated aneurysm formation. All but one patient developed an acute hemispheric neurologic deficit as the initial symptom. The deficit was transient in ten and prolonged in eight. The dissection occurred in the outer layers of the media. None of the surgical specimens showed atherosclerosis. Surgical methods of management included segmental resection and grafting, thrombectomy and intimectomy, dilation, and simple ligation. Considerable improvement of luminal diameter occurred in six of seven patients whose arteries were left undisturbed.
19例患者经动脉造影诊断为自发性、非创伤性颈内动脉夹层，其中10例经手术证实。始于或约始于颈动脉球部并止于骨管的锥形狭窄是一致的发现。4例患者伴有动脉瘤形成。除1例患者外，所有患者均以急性半球性神经功能缺损为首发症状。10例患者的缺损为短暂性，8例为持续性。夹层发生在中膜外层。所有手术标本均未显示动脉粥样硬化。手术治疗方法包括节段性切除和移植、血栓切除术和内膜切除术、扩张术以及单纯结扎术。7例未受干扰的动脉患者中有6例管腔直径有明显改善。
