颈性眩晕的椎动脉颅内段(V_4段)血管形态病理学改变

The Pathomorphological Change of the Intracranial Segment of Vertebral Artery Related with Cervical Vertigo

[目的]探索颈性眩晕的椎动脉颅内段(V4段)血管形态病理学改变。[方法]回顾1999年至2011年以眩晕为主症,符合寰枕痛、恶心(呕吐)、耳鸣(耳塞)、视物模糊(视物旋转)4项症状中2项以上,经颅多普勒检测有椎-基底动脉血流速增快或减慢患者,采用椎-基底动脉CT血管造影三维重建技术(3D-CTA)的血管形态学影像资料1680例,观察椎动脉V4段血管形态病理学改变情况。[结果]颈性眩晕患者椎动脉V4段血管形态病理学有椎动脉血管纤细、椎动脉血管痉挛、椎动脉血管断续不显影、椎动脉血管缺如、椎动脉血管未吻合、椎动脉血管局限性狭窄、椎动脉血管瘤、椎动脉血管瘤伴钙化8种改变。[结论]颈性眩晕的椎动脉颅内段(V4段)存在8种血管形态病理学改变。根据这些病理改变,在临床上可以借此判断预后,选择不同手法进行针对性地治疗,指导患者在生活中的注意事项。

[Objective] To explore the pathomorphological change of the intracranial segment of vertebral artery（V4part） related with cervical vertigo.[Method] Reviewed 1680 cases between year 1999-2011 who had vertigo as primary symptom, associated with either of 2 or more symptoms as follows：atlanto occipital region pain, nausea（or vomit）, tinnitus（or ear stuffiness）, blurred vision（or rotation）. All the cases had TCD examination which showed over fast or too slow blood flow speed, and 3D-CTA examination（Three-Dimensional Computed Tomography Angiography）. The pathomorphological change of the intracranial segment of vertebral artery was observed through 3D-CTA technology. [Results] There are 8 kinds of pathomorphological changes in the intracranial segment of vertebral artery. They are tenuous vertebral artery, spasm vertebral artery, interrupted vertebral artery, vertebral artery congenital absence, un-anastomosis vertebral artery, localized stegnotic vertebral artery, vertebral artery aneurysm, or vertebral artery aneurysm associated with calcification. [Conclusion] There are 8 kinds of patho-morphological changes in the intracranial segment of vertebral artery related with cervical vertigo. According to these patho-morphological changes, we can judge the prognosis,choose different techniques to threat and conduct patients on the cautions in their daily life.