Cerebral Infarction Caused by the Blunt Component of a Penetrating Neck Trauma: Report of a Case

頸部穿刺傷之鈍傷成分導致腦血管梗塞－病例報告

鄭美麗(Mei-Li Cheng) ； 洪怡珣(Yi-Shiung Horng) ； 張權維(Chein-Wei Chang)

《中華民國復健醫學會雜誌》 24卷2期 (1996/12) Pp. 102-106

摘要

頸部穿刺傷中可能包含的鈍傷成分很容易被忽略，然而它卻可能造成腦血管梗塞。本篇報告一例二十三歲的男性病人，被螺絲起子刺傷右側頸部，當時除了局部血腫外，並無神經學上的異常。然而約在五十天之後，出現了左側肢體無力及感覺喪失的情形。發病當天時所做的頭部電腦斷層檢查並無異常變化，然而頸部都卜勒超音波檢查，顯示在右側內頸動脈有一內含血栓之血管瘤，頭頸部血管攝影檢查亦發現在內、外頸動脈分叉處有一血管瘤。因此在發病次日進行血管瘤結紮手術。其後的頭部電腦斷層追蹤檢查，於右側顳葉發現出血性梗塞。經過復健治療，病人可以行走，步態接近正常，日常生活活動亦可獨立完成。本文所報告之頸部刺傷而引起血管病變是腦血管梗塞之少見病因，可作為臨床診斷及治療上之參考。

並列摘要

The blunt component in a penetrating neck injury is easy to be overlooked and it may cause a subsequent cerebral infarction. We reported a man aged 23 years who suffered from weakness of left limbs after a penetrating neck trauma. Although initial brain CT revealed no focal lesions, the carotid duplex showed an aneurysm with thrombus at right internal carotid artery (ICA). The angiogram showed an aneurysm adjacent to the bifurcation of internal and external carotid arteries (ECA) with well opacification of right internal and external carotid arteries. Surgical ligation of the aneurysm was performed on the next day. Follow-up brain CT revealed a hemorrhagic infarction over right temporal lobe. After strenuous rehabilitation, he was able to ambulate without any assisting device and could perform daily activities independently. This report indicates that a penetrating neck trauma may provide a risk for cerebral infarction.

並列關鍵字

cerebral infarction ； penetrating wound ； blunt neck trauma