缺血性卒中不可忽视的病因——脑动脉夹层  

Cerebral artery dissection:a cause of ischemic stroke that cannot be ignored

作　　者：程学英[1] 王剑锋[1] 

机构地区：[1]大连医科大学附属大连市中心医院神经内科,辽宁大连116033

出　　处：《中国实用内科杂志》2014年第5期457-459,共3页Chinese Journal of Practical Internal Medicine

摘　　要：自发性脑动脉夹层是颈内动脉或椎动脉内膜下或外膜下血管壁损伤,导致血液流入血管壁内,形成壁内血肿。其占缺血性卒中病因的2%,是年龄<45岁青年卒中的主要发病原因。约有1/4患者发病前有头部外伤史。损伤部位栓子脱落引起神经功能缺损,动脉的扩张或巨大动脉瘤的占位效应也可引起局部缺血改变。目前被公认的治疗方法是抗血小板聚集或抗凝治疗,尚无循证医学证据证实哪种治疗切实有效。Spontaneous cerebrovascular dissections are subintimal or subadventitial cervical carotid and vertebral artery wall injuries,leading to the intrusion of blood into layers of the arterial wall （intramural hematoma）. They are the cause of as many as 2% of all ischemic strokes. Spontaneous dissections are the leading cause of stroke in patients younger than 45 years old,accounting for almost 1/4 of strokes in this population. A history of some degree of trivial trauma is present in nearly 1/4 of cases. Subsequent mortality or neurological morbidity is usually the result of distal ischemia produced by emboli released from the injury site, although local mass effect produced by arterial dilation or aneurysm formation can also occur. The currently accepted method of therapy remains antithrombotic medication in the form of either anticoagulation or antiplatelet agents;however, no class I medical evidence exists to prove which is more effective.

关 键 词：脑动脉夹层 缺血性卒中 

分 类 号：R743[医药卫生—神经病学与精神病学]