基底動脈段落成雙導致陣發性姿態變換性頭暈

Paroxysmal Positional Dizziness Caused by Segmental Duplication of the Basilar Artery

陳建志(Jiann-Jy Chen) ； 陳登郎(Dem-Lion Chen) ； 楊菁華(Chin-Hua Yang)

《北市醫學雜誌》 8卷2期 (2011/06) Pp. 142-147

https://doi.org/10.6200/TCMJ.2011.8.2.06

摘要

基底動脈「段落成雙」在全數血管造影中發現的機會為0.04%~0.6%不等，比較可能與胚胎時期（第5週）位於後腦之縱向神經動脈發展異常有關，需與動脈剝離或栓塞鑑別。一72歲男性，反覆陣發姿態變換性頭暈已經1年多，合併血管造影之磁振造影意外發現基底動脈下段具有一個大小1.74×0.84mm的血管環，確定是基底動脈「段落成雙」，可能因此增加後顱窩循環的血管阻力，在姿態性低血壓時引發後顱窩循環不穩。建議保守治療及生活習慣調整，往後1個月，病症發作減少，遂停止服藥。爾後1年，平均大約數週至數月才會陣發1次頭暈，生活習慣的調整可能是減少病症發作的原因。

關鍵字

陣發性頭暈 ； 段落成雙 ； 基底動脈

並列摘要

”Segmental duplication” (SD) of the basilar artery has a reported angiographic prevalence of 0.04% to 0.6%. It is presumed to occur as a result of maldevelopment during the fifth week of the fetal life, and should be differentiated from aortic dissection or embolism. A 72-year-old male presented with episodic positional dizziness for over one year. A magnetic resonance image/angiogram incidentally revealed a 1.74×0.84 mm vascular loop over the basilar artery, which confirmed a SD. We suggest that the SD increased the vascular resistance of the posterior circulation, which then led to transient unstable flow during postural hypotension. Conservative treatment and life-style changes were recommended. Over the following month, the symptom recurred less and less, and then medication was halted. Over the following year, the symptom only recurred at irregular intervals of several weeks or months. Thus it is possible that a simple life-style change may be able to prevent recurrence.

並列關鍵字

episodic dizziness ； segmental duplication ； basilar artery