外傷所致椎動脈剝離和遲發性小腦梗塞性中風：病例報告

Trauma-related Vertebral Artery Dissection with Delayed Onset Cerebellar Infarction: A Case Report

李宗穎(Tsung-Ying Li) ； 陳良城(Liang-Cheng Chen) ； 姜蜀海(Shuu-Hai Jiang) ； 林修平(Shiou-Ping Lin) ； 蔡高宗(Kao-Chung Tsai)

《台灣復健醫學雜誌》 32卷4期 (2004/12) Pp. 215-220

https://doi.org/10.6315/2004.32(4)07

摘要

年輕人小腦中風在臨床上並不常見，本文報告一位二十二歲男性，過去並沒有特殊病史，在做極限運動時不慎自腳踏車摔落，腳踏車把手撞擊左側鎖骨外側部位但未造成骨折。三天後發生頭痛、嚴重嘔吐及右側肢體無力而送醫治療，起初被診斷為疑似頭部外傷，經過一系列檢查後確定診斷為左側椎動脈剝離合併左側急性小腦、視丘及顳葉梗塞。經低分子量肝素(low-molecular-weight heparin)、抗血小板藥物和復健治療，病人有極佳的功能恢復。這一類的病人，儘早診斷和治療不但可以避免後續嚴重的併發症，配合積極性的復健，病人亦有較佳的預後。

關鍵字

復健 ； 雄動脈剝離 ； 低分子量肝素 ； 腳踏車意外 ； 小腦中風

並列摘要

Cerebellar stroke is uncommon in young patients. We report the case of a 22-year-old man with a delayed cerebellar infarction secondary to vertebral artery dissection caused by trauma. While riding a bicycle as part of an extreme sport, his left clavicle struck a bicycle handle. Evaluation in the emergency room led to a diagnosis of left shoulder contusion without fracture of clavicle or cervical spine. Headache, severe vomiting, and weakness of the right-sided limbs developed three days later, and he presented to emergency staff again. Head injury was initially suspected, but the diagnosis was left vertebral artery dissection with delayed-onset right cerebellar infarction. After low-molecular-weight heparin, anti-platelet medication, and rehabilitation, the patient has had a very good functional recovery. Early diagnosis and treatment can prevent serious complications related to vertebral artery dissection, as shown by the current patient, who has a good prognosis after advanced rehabilitation.

並列關鍵字

rehabilitation ； vertebral artery dissection ； low-molecular-weight heparin ； bicycle accident ； cerebellar infarction