自发性双侧颈内动脉夹层伴脑梗死一例并文献复习  

Spontaneous bilateral internal carotid artery dissection： a case report and literature review

作　　者：叶凡龙 王子高[3] 潘晓黎[1] 陈婕[1] 谢瑞满[2] 钟春玖[1] 金莉蓉[1] 

机构地区：[1]复旦大学附属中山医院神经内科,上海200032 [2]复旦大学附属中山医院老年科,上海200032 [3]复旦大学附属金山医院神经内科,上海201508

出　　处：《中华全科医师杂志》2017年第5期391-394,共4页Chinese Journal of General Practitioners

摘　　要：回顾性分析我院2016年诊治的1例自发性双侧颈内动脉夹层（ICAD）致脑梗死患者的临床资料，结合PubMed、万方及中国知网2000-2015年文献报道的44例自发性双侧ICAD患者资料，对其流行病学、病因、临床表现、影像学特点、治疗及预后进行分析。自发性双侧ICAD好发于中青年人群，主要临床表现为脑卒中（71．1％）、头颈部疼痛（62．2％）、Homer综合征（15．6％）及颅神经麻痹（11．1％），除全脑血管造影外，颈椎MRI T1W抑脂序列显示高信号的壁内血肿可明确诊断，抗栓治疗有效，总体预后良好。自发性ICAD是中青年人群卒中的重要原因，颈椎MRI T1WI抑脂序列检查有助于早期诊断及临床干预。A patient with multiple ischemic stroke due to spontaneous bilateral internal carotid artery dissection （ICAD） was reported and the epidemiology, neuroimaging, clinical characteristics and treatment of spontaneous bilateral ICAD were reviewed. Spontaneous bilateral ICAD mostly occurs in young and middle-aged individuals and the clinical manifestations are mainly stroke （71.1% ）, headache and neck pain （62. 2% ）, Homer＇s syndrome（ 15.6% ） and cranial nerve palsy（ 11.1% ）. Cervical axial T1-weighted fat- suppressed image is an alternative to DSA to make the definite diagnosis. Antithrombotic therapy is regularly used and the general clinical outcome is good. Cervical arterial dissection is one of the most common causes of stroke in young and middle-aged patients. Cervical MRI T1-weighted fat suppressed image is crucial for timely diagnosis and initiation of appropriate ciinical intervention.

关 键 词：颈内动脉夹层 脑梗死 颈椎磁共振 

分 类 号：R743.3[医药卫生—神经病学与精神病学]