PDF(Pubmed)
Abstract：
UNASSIGNED: There is no established treatment strategy for traumatic vertebral artery occlusion that does not require cervical spine repair surgery.
UNASSIGNED: A 49-year-old man was brought to our hospital with traffic trauma. Fractures were observed in the left lateral mass and transverse process of Atlas and the left vertebral artery was occluded at the level of the foramen transversum of Atlas. No acute cerebral infarction was observed. Because the cervical spinal cord was not compressed by the fracture, no repair surgery was performed. Continuous intravenous heparin and oral aspirin were started for traumatic vertebral artery occlusion. Thereafter, the left vertebral artery spontaneously recanalized, but no cerebral infarction was observed. The patient was discharged home on day 16 of injury. Four days later, however, he was brought to our hospital with nausea and lightheadedness. Acute cerebral infarction was observed in the left posterior inferior cerebellar artery territory and a thrombus in the left vertebral artery V4 segment. Parent artery occlusion was performed to prevent further cerebral infarction due to distal embolization of the thrombus. No further cerebral infarction occurred after the operation and the patient was discharged home with a modified Rankin scale score of 1.
UNASSIGNED: In cases of traumatic vertebral artery occlusion without an occlusive mechanism, parent artery occlusion may be considered in terms of recanalization risk, regardless of the need for repair surgery.
UNASSIGNED: A 49-year-old man was brought to our hospital with traffic trauma. Fractures were observed in the left lateral mass and transverse process of Atlas and the left vertebral artery was occluded at the level of the foramen transversum of Atlas. No acute cerebral infarction was observed. Because the cervical spinal cord was not compressed by the fracture, no repair surgery was performed. Continuous intravenous heparin and oral aspirin were started for traumatic vertebral artery occlusion. Thereafter, the left vertebral artery spontaneously recanalized, but no cerebral infarction was observed. The patient was discharged home on day 16 of injury. Four days later, however, he was brought to our hospital with nausea and lightheadedness. Acute cerebral infarction was observed in the left posterior inferior cerebellar artery territory and a thrombus in the left vertebral artery V4 segment. Parent artery occlusion was performed to prevent further cerebral infarction due to distal embolization of the thrombus. No further cerebral infarction occurred after the operation and the patient was discharged home with a modified Rankin scale score of 1.
UNASSIGNED: In cases of traumatic vertebral artery occlusion without an occlusive mechanism, parent artery occlusion may be considered in terms of recanalization risk, regardless of the need for repair surgery.
摘要：
■对于不需要进行颈椎修复手术的创伤性椎动脉闭塞，尚无既定的治疗策略。
■一名49岁男子因交通创伤被送往我们医院。在Atlas的左侧块和横突观察到骨折，在Atlas的横穿孔水平闭塞了左椎动脉。未观察到急性脑梗死。因为颈脊髓没有被骨折压缩，未进行修复手术.开始连续静脉注射肝素和口服阿司匹林治疗外伤性椎动脉闭塞。此后,左椎动脉自发再通,但未观察到脑梗塞。患者在受伤的第16天出院。四天后,然而,他因恶心和头晕被带到我们医院。在左小脑后下动脉区域观察到急性脑梗死，在左椎动脉V4段观察到血栓。由于血栓的远端栓塞，进行了父母动脉闭塞以防止进一步的脑梗死。术后未再发生脑梗死，患者出院，改良Rankin量表评分为1分。
■在没有闭塞机制的创伤性椎动脉闭塞的情况下，可以根据再通风险来考虑父动脉闭塞，无论是否需要修复手术。
■一名49岁男子因交通创伤被送往我们医院。在Atlas的左侧块和横突观察到骨折，在Atlas的横穿孔水平闭塞了左椎动脉。未观察到急性脑梗死。因为颈脊髓没有被骨折压缩，未进行修复手术.开始连续静脉注射肝素和口服阿司匹林治疗外伤性椎动脉闭塞。此后,左椎动脉自发再通,但未观察到脑梗塞。患者在受伤的第16天出院。四天后,然而,他因恶心和头晕被带到我们医院。在左小脑后下动脉区域观察到急性脑梗死，在左椎动脉V4段观察到血栓。由于血栓的远端栓塞，进行了父母动脉闭塞以防止进一步的脑梗死。术后未再发生脑梗死，患者出院，改良Rankin量表评分为1分。
■在没有闭塞机制的创伤性椎动脉闭塞的情况下，可以根据再通风险来考虑父动脉闭塞，无论是否需要修复手术。
