外伤致椎动脉夹层性脑梗死1例并文献复习

Traumatic Vertebral Artery Dissection Cerebral Infarction:A Case Report and Literature Review

颈部动脉夹层(cervical artery dissection,CAD)是一种因颈部动脉内膜撕裂而引发血液流入颈部动脉管壁内所形成的壁内血肿,主要分为颈内动脉夹层和椎动脉夹层两种.CAD的发生常会导致动脉狭窄、闭塞或动脉瘤样改变等严重后果.目前,多数报道集中在颈内动脉狭窄的相关疾病,而对椎动脉狭窄的报道较少,对其导致脑梗死的报道则更为少见.现对1例因外伤形成的椎动脉夹层而引起椎动脉狭窄,最终导致脑梗死的青年男性病例进行报道.该患者经过系统的药物治疗,在3个月后的随诊中发现椎动脉狭窄情况改善.椎动脉狭窄导致的脑梗死较为少见,临床上可能会造成漏诊和误诊,因此该文对患者情况进行报道,以期为临床提供一定的参考.

Cervical artery dissection(CAD)is a kind of intramural hematoma caused by blood flowing into the neck artery wall due to the tear of the carotid intima.It is mainly divided into two types:internal carotid artery dissection and vertebral artery dissection.The occurrence of CAD often leads to the serious consequences such as arterial stenosis,occlusion or aneurysmal change.At present,most reports focus on diseases related to internal carotid artery stenosis,while there are few reports on vertebral artery stenosis,especially the reports on cerebral infarction caused by it.We report a case of a young male with vertebral artery stenosis and cerebral infarction due to traumatic vertebral artery dissection.The patient underwent systematic medication and was found to have improved vertebral stenosis at follow-up after three months.Cerebral infarction caused by vertebral artery stenosis is relatively rare,which may lead to missed diagnosis and misdiagnosis in clinic.Therefore,this paper reports the patient's situation in order to provide some reference for clinical practice.