双侧自发性椎动脉夹层一例  

A case report of bilateral spontaneous vertebral dissection

作　　者：张志勇[1] 董致郅[2] Zhang Zhiyong;Dong Zhizhi(Department of Neurology,ChinaJapan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院神经科,北京100029 [2]北京市怀柔区中医医院脑病科

出　　处：《中国脑血管病杂志》2020年第4期207-210,共4页Chinese Journal of Cerebrovascular Diseases

摘　　要：椎动脉夹层是引起后循环青年卒中重要的病因,其单侧病变多见,且大多患者有明确的外伤史,双侧自发性椎动脉夹层少见.既往研究表明,颅外段椎动脉夹层给予抗血小板聚集和抗凝治疗均有效,且在监测手段上,高分辨率MRI对动脉管壁结构显示优于其他检查手段,故在椎动脉夹层的诊治及随访方面均有明显优势.该研究报道了1例经高分辨率MRI确诊及连续追踪的双侧椎动脉颅外段自发性夹层的罕见案例,该例患者源于一侧起病,虽经双重抗血小板聚集治疗但对侧出现了再发夹层,该研究结合文献对其诊治特征进行了分析.Vertebral artery dissection is an important cause of posterior circulation stroke in young adults.There is common with unilateral dissection of the vertebral artery but is rare with bilateral spontaneous dissection.Most cases are caused by a clear history of trauma.Previous studies have pointed out that antiplatelet or anticoagulation treatment for extracranial vertebral artery dissection is effective.In recent years,highresolution magnetic resonance imaging has shown the superiority to observe the arterial wall structures compared to other methods,which has obvious advantages in the diagnosis,treatment and followup of arterial dissection.The study reports a rare case of spontaneous dissection of the extracranial segment at the bilateral vertebral artery confirmed by highresolution magnetic resonance imaging and continuous followedup.The case demonstrates that the dissection originated from one side,and then the contralateral side developed dissection despite dualantiplatelet therapy.In this article,the team analyze and discuss its treatment plan combined with the relevant literature.

关 键 词：磁共振成像 高分辨率磁共振成像 椎动脉夹层 青年卒中 抗凝药 血小板聚集抑制剂 

分 类 号：R743.3[医药卫生—神经病学与精神病学]