Abstract：
Young adults who present to the ED with neck pain following non-penetrating, seemingly trivial trauma to the neck, are at risk of neck artery dissection and subsequent stroke. Sport-related neck injury is the chief cause. Physical examination may often be unremarkable, and although there may be reluctance to expose young patients to radiation, radiological imaging is central to making a diagnosis of arterial wall disruption. A comprehensive literature search was performed in relation to neck artery dissection, and the evidence was scrutinised. We discuss the typical mechanism of injury, symptoms, anatomical considerations and clinical aids in diagnosis of neck artery dissection. Although the incidence is low, neck artery dissection has a mortality of 7%. As such, it is important for front-line physicians to have a high suspicion of the diagnosis and a low threshold to organise radiological examinations, specifically computerised tomography. Early detection of neck artery dissection will trigger clinical protocols that call for multi-disciplinary team management of this condition. In general, guideline-based recommendation for the management of neck artery dissection involving an intimal flap is by anti-platelet therapy while treatment of neck artery dissection that results in a pseudo-aneurysm or thrombosis is managed by surgical intervention or endovascular techniques. Close follow up combined with antithrombotic treatment is recommended in these individuals, the goal being prevention of stroke.
摘要：
在非穿透性后出现颈部疼痛的年轻成年人，颈部看似微不足道的创伤，有颈动脉夹层和随后中风的风险。运动相关的颈部损伤是主要原因。体格检查通常不明显，尽管可能不愿意让年轻患者接受辐射，放射学成像是诊断动脉壁破裂的核心。对颈部动脉夹层进行了全面的文献检索，证据被仔细检查了。我们讨论了损伤的典型机制，症状,解剖学考虑和临床辅助诊断颈动脉夹层。虽然发病率低,颈动脉夹层的死亡率为7%.因此，对一线医生来说，对诊断有高度怀疑和组织放射检查的门槛很低是很重要的，特别是计算机断层扫描。早期发现颈部动脉夹层将触发临床协议，要求多学科团队管理这种情况。总的来说,涉及内膜瓣的颈动脉夹层的治疗基于指南的建议是通过抗血小板治疗,而导致假性动脉瘤或血栓形成的颈动脉夹层的治疗则通过手术干预或血管内技术进行.对这些患者建议密切随访结合抗血栓治疗，目标是预防中风。
