Traumatic Internal Carotid Artery Dissection Complicated with Ischemic Cerebral Infarction

外傷性內頸動脈剝離合併缺血性腦中風

黃維正(Wei-Cheng Huang) ； 周立偉(Li-Wei Chou) ； 羅瑞寬(Sui-Foon Lo) ； 孟乃欣(Nai-Hsin Meng) ； 高木榮(Mu-Jung Kao)

《北市醫學雜誌》 6卷1期 (2009/02) Pp. 65-70

https://doi.org/10.6200/TCMJ.2009.6.1.07

摘要

缺血性腦中風約佔全部中風病例百分之八十，多發生於中老年人，其發病可能原因包括血管栓塞及血栓形成。外傷性頸動脈剝離亦為一種可能併發缺血性腦中風的急症，相對多發生於年輕人。我們此次探討一位年輕男性個案，於頸部穿刺傷後併發意識障礙，利用電腦斷層和血管攝影診斷為外傷性內頸動脈剝離併發左側中大腦動脈缺血性梗塞。經內頸動脈支架放置及顱骨切除手術後恢復意識，惟仍殘留右側肢體偏癱及失語症等神經症狀。透過此罕見病例，我們必須謹記頸部創傷併發大腦缺血性中風之病患，須將外傷性頸動脈剝離列入鑑別診斷，以利早期介入治療，並透過積極復健，以使患者儘早回復日常生活功能。

關鍵字

頸動脈剝離 ； 腦中風 ； 創傷性

並列摘要

Acute ischemic stroke refers to stroke caused by thrombosis or embolism and accounts for 80% of all strokes; it is also most seen among the elderly. Traumatic carotid artery dissection is a serious condition that may cause ischemic stroke in young patients. We report on a patient with a penetrating injury on the left side of the neck, presented with loss of consciousness and weakness in right limbs. The definitive diagnosis was left carotid artery dissection with left middle cerebral artery (MCA) territory infarction. It was based on diagnostic angiogram intervention. A computed tomographic (CT) scan also revealed left-sided cerebral infarction with mass effect within the middle cerebral artery territory. The diagnosis of carotid artery dissection should always be kept in mind when a young patient presents with ischemic change in the brain and focal signs in the clinical examination.

並列關鍵字

carotid artery dissection ； infarction ； traumatic