椎动脉夹层六例临床诊断和预后

《椎动脉夹层六例临床诊断和预后》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。

1、万方数据·816·生堡控丝型塞蠢!堂生!!旦筮兰!鲞筮!!期要!也』盟丝咝，堕!畦壁!Q堡，!堕：堡!：丛生12椎动脉夹层六例临床诊断和预后李志立黄一宁【摘要】目的探讨椎动脉夹层的临床特点、诊断、治疗和预后。方法6例表现为急性后循环障碍导致脑缺血的患者，经询问病史、体检、常规检查及DSA、MRI、MRA及颈部血管超声等检查，总结临床上椎动脉夹层的诊疗过程。结果起病时有突发颈、枕痛者4例，发病时全部伴有眩晕或头晕，临床上2例表现为Walleuberg综合征；3例有明确颈部外伤史；影像学特点：DSA示椎动脉闭塞或狭窄，MRI示壁内血肿，颈部血管超声示残

2、端样血流信号或线样血流，未发现有血管内膜增厚及动脉粥样硬化斑块；6例椎动脉夹层中5例发生在颅外段；平均随诊26个月，经过抗凝治疗。改良的RankinScale评分分别由病初的4⋯442、2,2分提高到随诊时的4、3、2、1、0、1分，经配对秩和检验．差异有统计学意义(Z=一2．07，P=0．038)。结论椎动脉夹层动脉瘤有特殊的临床表现，诊断并不困难，经长期抗凝治疗，血管可以再通，临床预后较好。【关键词】动脉瘤，假性；椎底动脉供血不足；抗凝药；预后Oiulealmanifestationsandoutcomeofvertebralarteryd趣豫

3、嘣蚰：6case8studiesⅡZhi．玩棚m^『GK一，“硌DepartmentofNeurology，theFirstHospitalofPekingUnivemity，Bering100034，ChinaCorrespondingauthor：HUANGYi—ning，Email：npku@yahoacn【Abstract】ObjectiveToassesstheclinicalfeatures，diagnosis，therapyandtheprognosisofvertebralarterydissectionpresentedagisc

4、hemiecerebralvasculardisense．MethodsClinicalandroutinelaboratoryexaminationswereperformedinallthe6patients．whounderwentbrainDSA。MBI．MRAandcervicalvascularduplexultrasoundexaminations．r11lev缸lfiUedatleastl0f2imagingcriteriausedtodiagnosevertebraldissection．ResultsTherewassudden

5、neckpainoroccipitalheadachein4oftIle6cages．Vertigoand(or)dizzinesswerethemainonsetsymptomsforallthesubjects．TwocasespresentedWallenbergsyndrome：ThreehadrecenttraumatotheneckDSAshowedocclusionorstenosisofthevertebralartery．MRIshowedancrescent．shapedintramuralhematoma．CervicalVa

6、scularduplexultrasoundrevealednormalintima．mediathicknessandnocarotidatherosclemticplaque．anddisplayedsignificantstenosisorocclusionoftheinvolvedvertebralartery．Thedissectionswerefoundintheextracranialsejz，nentofthevertebralarteryin5cases．Thefollowupperiodforallpatientswasappr

7、oximately26months．Theanticoagulanttherapywasadministeredtoausubjectsforaperiodrangingfrom9to53months．，11lemodifiedRankinScale(mRS)improvedsignificantlyascomparedtobaselinesinallexceptforonecage，themRswere4，4，4，2，2，2嬲4，3，2，1，0，l(Z=一2．07，P=0．038)．ConclusionsVertebralarterydissec

8、tionhasuniquechnicalfeatures．Neuroimngingisusefulinconfirming