- 期刊
頸動脈支架置放術後之頸動脈疼痛－病例報告
Carotid Stenting Related Carotidynia: A Case Report
摘要
頸動脈疼痛是一種較鮮為人知的顱顏頸部疼痛，有別於一般感染疾病所致之疼痛。一74歲男性，有高血壓、心臟病及高血脂症，因兩側內頸動脈狹窄發生兩次左側大腦梗塞，接受左側內頸動脈之經皮動脈成型術。術後發生左側頸部第II區的疼痛，理學檢查顯示左側內頸動脈有壓痛，而非扁桃腺炎，頸部攝片僅顯示位於左側頸部之頸動脈支架，並無急性會厭炎之大拇指徵候，確定是頸動脈疼痛。口服acetaminophen並無法減輕疼痛，但在給予diclofenac後緩解。爾後追蹤3個月，並無疼痛復發。內頸動脈支架置放術後所併發之頸動脈疼痛，若沒有完整的病程回顧，的確很難與頸椎疾患、感染、甲狀腺疾患、齒源性病因、顳顎關節疾患及三叉神經痛等較為常見且廣為人知的顱顏頸部疼痛分別。本個案症具教育意義，特提出報告。
並列摘要
Carotidynia is a less-known craniofacial and neck pain disorder, and different from a common infectious disease. A 74-year-old man with hypertension, heart disease and hyperlipidemia has experienced twice left cerebral infarction due to bilateral internal carotid arterial (ICA) stenosis. Therefore, percutaneous transluminal angioplasty was recommended for the left ICA. However, post-procedure pain occurred at the left neck level II region, and the physical examination demonstrated left ICA tenderness rather than tonsillitis. Neck films demonstrated a left ICA stent rather than an epiglottic thumb sign of acute epiglottitis, so carotidynia was identified. The carotidynia was then cured by diclofenac rather than acetaminophen. Over the following 3 months, carotidynia did not recur. If without disease-course review, it is difficult to differentiate carotid stenting related carotidynia from those common and well-known causes of neck and craniofacial pain, such as vertebral problems, infectious causes, thyroid diseases, odontogenic causes, temporomandibular joint problems and trigeminal neuralgia. We reported the curious case herein for education.
延伸閱讀
- 蘇淑芬、蘇宣穎、吳孟珊（2018）。頸動脈狹窄患者置放頸動脈支架之護理。護理雜誌，65(6)，104-110。https://doi.org/10.6224/JN.201812_65(6).13
- 陳伊呈、溫高榮、蔡明忠、張克中、王本欽、萬漢雷（1993）。頸部大型動靜脈血管畸形之手術治療－病例報告。中華民國重建整形外科醫學會雜誌，2(2)，26-32。https://doi.org/10.7096/JPRSA.199309.0026
- 蔡春泉、呂鎮中、祁志勵、衛優遊（1983）。頸部動靜脈畸形及腫瘤手術前之外頸動脈栓塞術－病例報告。中華放射線醫學雜誌，8(4)，356-362。https://www.airitilibrary.com/Article/Detail?DocID=10188940-198312-8-4-356-362-a
- 秀曉敏、黃穰基、陳嘉瑋（1996）。頸部壞死性筋膜炎及胸腔并發症－病例報告及文獻回顧。中華民國口腔顎面外科學會雜誌，7(1)，15-26。https://doi.org/10.7104/CJOMS.199603.0015
- Picchetto, L., Spalletta, G., Casolla, B., Cacciari, C., Cavallari, M., Fantozzi, C., Ciuffoli, A., Rasura, M., Imperiale, F., Sette, G., Caltagirone, C., Taurino, M., & Orzi, F. (2013). Cognitive Performance following Carotid Endarterectomy or Stenting in Asymptomatic Patients with Severe ICA Stenosis. Cardiovascular Psychiatry and Neurology, 2013(), 55-60. https://doi.org/10.1155/2013/342571