Abstract:
Syncope is a common clinical entity with variable presentations and often an elusive causal mechanism, even after extensive evaluation. In any case, global cerebral hypoperfusion, resulting from the inability of the circulatory system to maintain blood pressure (BP) at the level necessary to supply blood to the brain efficiently, is the final pathway for syncope. Steno-occlusive carotid artery disease, even if bilateral, does not usually cause syncope. However, the patient presented here had repeated syncope attacks and underwent a thorough examination for suspected cardiac disease, but no abnormality was found. Since there was severe stenosis in the right unilateral internal carotid artery (ICA), but no stenosis in the left ICA or vertebrobasilar artery (VBA), and transient left mild hemiparesis associated with syncope, carotid revascularization surgery for the right ICA was performed, and the repeated syncope attacks completely disappeared after the surgery. The patient\'s condition improved markedly, and no further episodes of syncope have been reported. We report the relationship between carotid artery stenosis and syncope and discuss its pathomechanism.
摘要:
晕厥是一种常见的临床实体,表现可变,通常是一种难以捉摸的因果机制,即使经过广泛的评估。无论如何,全脑灌注不足,由于循环系统无法将血压(BP)维持在有效向大脑供血所必需的水平,是晕厥的最终途径。闭塞性颈动脉疾病,即使是双边的,通常不会引起晕厥。然而,这里介绍的患者反复晕厥发作,并接受了疑似心脏病的彻底检查,但没有发现异常。由于右侧单侧颈内动脉(ICA)严重狭窄,但左侧ICA或椎基底动脉(VBA)无狭窄,与晕厥相关的短暂左侧轻度偏瘫,右ICA行颈动脉血运重建术,反复的晕厥发作在手术后完全消失了。病人的病情明显改善,没有进一步的晕厥发作的报道。我们报告颈动脉狭窄与晕厥之间的关系,并讨论其发病机制。