颅外椎动脉进入C6椎体横Foramen后夹层致基底动脉闭塞1例报告。

JNET Pub Date : 2023-01-01 Epub Date: 2023-08-29 DOI:10.5797/jnet.cr.2023-0039
OhgakiFukutaro, TakaderaMutsumi, OkanoMasayuki, TatezukiJunya, MochimatsuYasuhiko
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摘要

目的:基底动脉闭塞(BAO)是一种罕见的急性危及生命的中风,可能继发于椎动脉夹层(VAD)。VAD是自发发生的,有时是由颈部的机械应力或钝器创伤引起的,有时发生在V1-V2交界处,但这种情况的报道并不多。在此,我们报告了一例BAO后V1-V2交界处VAD的图片说明和临床资料。病例介绍:患者是一名27岁的女性,因突然严重昏迷被转移到我们医院。入院时,她出现全身抽搐和呼吸停止,全身CT和CTA显示BAO。我们进行了机械血栓切除术并实现了基底动脉的再通,她在C6横孔(V1-V2交界处)入口处被诊断为继发于右侧VAD的BAO。事后看来,她在发病前就有肩胛骨和背部疼痛。发病90天后,她恢复了,改良的兰金量表评分为3。结论:VAD有时发生在进入C6椎横孔处。在这种情况下,VAD可能受到轻微创伤的影响,并可能因胚胎发育过程而导致组织学脆弱。尽管BAO有时很难诊断,因为它表现出各种症状,但在年轻人和健康人出现颈部、肩胛骨或背痛之前突然严重昏迷的情况下,应考虑继发于VAD的BAO。
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Basilar Artery Occlusion Caused by Extracranial Vertebral Artery Dissection on Its Entry into the Transverse Foramen of the C6 Vertebra: Case Report.

Objective: Basilar artery occlusion (BAO) is an infrequent form of acute life-threatening stroke and may occur secondary to vertebral artery dissection (VAD). VAD, which occurs spontaneously and sometimes results from mechanical stress or blunt force trauma to the neck, sometimes occurs in the V1-V2 junction, but there are not many reported cases of those. Herein, we report a pictorially illustrative and clinically informative case of VAD in the V1-V2 junction following BAO.

Case presentation: The patient was a 27-year-old woman who was transferred to our hospital with abrupt severe unconsciousness. On admission, she presented with generalized convulsions and respiratory arrest, and pan-scan CT and CTA indicated BAO. We performed mechanical thrombectomy and achieved recanalization of the basilar artery, and she was diagnosed with BAO secondary to the right VAD at the entry of the C6 transverse foramen (V1-V2 junction). In hindsight, she had scapula and back pain before the onset. She recovered with a modified Rankin scale score of 3 after 90 days from the onset.

Conclusion: VAD sometimes occurs at its entry into the transverse foramen of the C6 vertebra. In this case, VAD may be affected by minor trauma and potentially histological fragility due to the embryonic development process. Although BAO is sometimes difficult to diagnose because it presents with various symptoms, BAO secondary to VAD should be considered in cases of abrupt severe unconsciousness preceded by neck, scapula, or back pain in young and healthy persons.

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来源期刊
自引率
0.00%
发文量
38
审稿时长
17 weeks
期刊介绍: JNET Journal of Neuroendovascular Therapy is the official journal of the Japanese Society for Neuroendovascular Therapy (JSNET). The JNET publishes peer-reviewed original research related to neuroendovascular therapy, including clinical studies, state-of-the-art technology, education, and basic sciences.
期刊最新文献
Basilar Artery Occlusion Caused by Extracranial Vertebral Artery Dissection on Its Entry into the Transverse Foramen of the C6 Vertebra: Case Report. Mechanical Thrombectomy and Parent Artery Occlusion for Acute Basilar Artery Occlusion Due to Vertebral Fracture and Artery Dissection: A Case Report. Stent-Assisted Coil Embolization of Ruptured Aneurysms in the Acute Stage: Advantages and Disadvantages. Treatment Outcomes of 94 Cases of Pipeline Embolization Device in a Single Center: Predictive Factors of Incomplete Aneurysm Occlusion. Endovascular Treatment of Anterior Cranial Fossa Dural Arteriovenous Fistula
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