外伤性颈内动脉闭塞致急性缺血性卒中:1例报告及文献复习

韩 瑛,汤同健,许文杰,詹 青

神经病学与神经康复学杂志 ›› 2017, Vol. 13 ›› Issue (3) : 151-156.

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神经病学与神经康复学杂志 ›› 2017, Vol. 13 ›› Issue (3) : 151-156. DOI: 10.12022/jnnr.2017-0023
病例报告

外伤性颈内动脉闭塞致急性缺血性卒中:1例报告及文献复习

  • 韩 瑛,汤同健,许文杰,詹 青
作者信息 +

Acute ischemic stroke caused by traumatic internal carotid artery occlusion: One case report and literature review

  • HAN Ying, TANG Tongjian, XU Wenjie, ZHAN Qing
Author information +
文章历史 +

摘要

目的:报道1例因外伤性颈内动脉闭塞致急性缺血性卒中患者的临床诊治经过,并对相关文献进行复习。 方法:报道1例因外伤性颈内动脉闭塞致急性缺血性卒中患者的临床诊疗经过。同时,结合相关文献对外伤性颈内动脉闭塞的临床特征和诊治进展进行复习。 结果:1例外伤性颈内动脉闭塞患者发生急性缺血性卒中而接受静脉溶栓治疗。治疗2周后,患者右侧肢体功能恢复,仅遗留部分运动性失语;美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分为2分。治疗6周后,复查颈动脉计算机断层摄影血管造影(computed tomography angiography,CTA),提示左侧颈总动脉近段狭窄,其远端颈总动脉闭塞直至颈总动脉分叉处。于是行左侧颈动脉内膜剥脱术+取栓术+颈动脉支架成形术。术后随访,患者预后良好。 结论:对于外伤性颈内动脉闭塞致急性缺血性卒中的患者,可基于指南推荐,进行个体化治疗。在溶栓时间窗内及时进行静脉溶栓治疗,可以改善患者的预后。

Abstract

Objective: To report the diagnosis and treatment of a patient with acute ischemic stroke caused by traumatic internal carotid artery occlusion, and review the related literatures. Methods: The clinical diagnosis and treatment of a patient with acute ischemic stroke caused by traumatic internal carotid artery occlusion was reported. The clinical characteristics of traumatic internal carotid artery occlusion and the related progress in diagnosis and treatment of this disease were reviewed. Results: A patients with acute ischemic stroke caused by traumatic internal carotid artery occlusion received intravenous thrombolysis. After 2-week treatment, the right limb function was recovered, only leaving moderate motor aphasia, and the National Institute of Health Stroke Scale (NIHSS) score was 2. After 6-week treatment, the carotid artery computed tomography angiography (CTA) suggested the proximal stenosis of left common carotid artery and the distal common carotid artery occlusion extending to the bifurcation of the common carotid artery. Then the left carotid endarterectomy was performed with embolectomy and carotid angioplasty and stenting. After operation, the patient was followed-up, and the prognosis was good. Conclusion: For patients with acute ischemic stroke caused by traumatic internal carotid artery occlusion, individualized treatment is recommended on the basis of guidelines. The thrombolytic therapy in time window can improve the prognosis of the patients.

关键词

外伤性颈内动脉闭塞 / 急性缺血性卒中 / 静脉溶栓 / 计算机断层摄影血管造影

Key words

Traumatic internal carotid artery occlusion / Intravenous thrombolysis / Acute ischemic stroke / Computed tomographic angiography

引用本文

导出引用
韩 瑛,汤同健,许文杰,詹 青. 外伤性颈内动脉闭塞致急性缺血性卒中:1例报告及文献复习[J]. 神经病学与神经康复学杂志. 2017, 13(3): 151-156 https://doi.org/10.12022/jnnr.2017-0023
HAN Ying, TANG Tongjian, XU Wenjie, ZHAN Qing. Acute ischemic stroke caused by traumatic internal carotid artery occlusion: One case report and literature review[J]. Journal of Neurology and Neurorehabilitation. 2017, 13(3): 151-156 https://doi.org/10.12022/jnnr.2017-0023

参考文献

[1] 王成林, 林 贵. 罕见病少见病的诊断与治疗[M]. 北京: 人民卫生出版社, 1999:339-340.
[2] Aarabi B, McQeen JD. Traumatic internal carotid occluation at the base of the skull[J]. Surg Neurol, 1978, 10(4):233-236.
[3] Patel TR, Schielke GP, Hooff JT, et al. Comparison of cerebral blood flow and injury following intracerebral and subdural hematoma in the rat[J]. Brain Res, 1999, 829(1-2):125-133.
[4] 刘景萍, 李慧芳, 胡 健, 等. 双功能彩超与经颅多普超声对颈内动脉狭窄或闭塞的临床价值[J]. 中国医药导报, 2012, 9(27):100-102.
[5] Bodanapally UK, Shanmuganathan K, Boscak AR, et al. Vascular complications of penetrating brain injury: comparison of helical CT angiography and conventional angiography[J]. J Neurosurg, 2014, 121(5):1275-1283.
[6] 王桂杰. 高场强3DCE-MRA在脑卒中筛查中的应用研究[J]. 中国医药科学, 2013, 3(1):63-65.
[7] 王 涌, 陈 莉, 王 怡. 脑动脉闭塞或狭窄的经颅彩色多普勒超声与CT血管造影诊断:125例脑梗死患者研究[J]. 中国医学计算机成像杂志, 2012, 18(1):54-57.
[8] 张天奇. 急性颈内动脉闭塞的动脉溶栓治疗[J]. 航空航天医学杂志, 2014, 25(11):1521-1522.

基金

上海中医药大学校级科研项目(编号:2016YG36)

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