颈部夹层动脉导致缺血性脑卒中17例临床分析

Cervical Artery Dissection and Ischemic Stroke—17 Cases Report

目的:探讨颈部夹层动脉(CAD)缺血性脑卒中的临床表现。方法:收集我中心前瞻性登记数据库中的17例(共18支病变血管)经DSA全脑血管造影证实的、因CAD所致缺血性脑卒中患者的资料,对其归纳分析。结果:CAD所致缺血性脑卒中和短暂性脑缺血发作(TIA)占同期该年龄段缺血性脑卒中和TIA的7.49%(17/227)。所有患者均因TIA或局灶神经功能缺损就诊;头颅MRI和DSA均发现特征性征象,颈内动脉夹层(ICAD)与椎动脉夹层(VAD)的构成比为16/2;所有患者均接受抗凝、抗血小板聚集治疗,其中6例行支架置入术。随访2个月所有患者均获得一定程度的神经功能恢复。结论:ICAD较VAD常见,TIA或局灶神经功能缺损症候结合特征性的影像学改变是诊断CAD的主要线索和依据。

Aim： To study the clinical feature of stroke caused by carotid artery dissection（CAD）. Methods. The data about the clinical features, treatment and outcomes of 17 ischemic stroke patients obtained from prospective stroke registry of our hospital were reviewed and analyzed. The diagnosis of CAD of all patients were definitely made out by DSA. Results. 7.49% ischemic stroke in this age was caused by CAD. All the patients presented of TIA and/or ischemic stroke at admission time, characteristic signs can be found in cranial MRI, Color Doppler Imaging of Carotid Arteries and DSA, The constituent ratio of internal carotid artery dissection（ICAD） to vertebral artery dissection（VAD） was 16/2. All patients accepted anticoagulation therapy, anti-platelet aggregation treatment and 6 patients accepted carotid angioplasty and stenting.The followingup data after 2 months showed all the patient got improvement of neurological function. Conclusion ： Our data indicated that the incidence of CAD is more common in ICAD than in VAD, TIA and focal neurological deficits combined with characteristic signs in cranial MRI, Color Doppler Imaging of Carotid Arteries and DSA were vital clues for making diagnosis.