尽管颈动脉夹层是年轻患者缺血性卒中的主要原因之一,脑缺血的急性治疗和急性后一级或二级预防在不同的中心和国家有显著差异.这些差异反映在主要中风协会的指南建议的差异上。我们的叙述性综述旨在阐明中风协会指南声明中的不同建议,并概述有关颈动脉夹层患者的急性管理和急性后治疗的现有文献。总的来说,建议静脉溶栓和机械取栓,不管中风的病因,如果在标签内施用。脑缺血的二级预防可以通过抗血小板摄入或抗凝,with,到目前为止,两种治疗都没有确立优势。抗血栓治疗的持续时间,他汀类药物的使用以及最佳的血管内途径仍有待争论,需要进一步评估。此外,它仍然是未知的,任何指南声明中给出的建议是否与自发性和创伤性颈动脉夹层相似,因为没有一个中风社会能区分这两者。
Even though cervical artery dissection is one of the main reasons for ischemic stroke in young patients, acute management and post-acute primary or secondary prevention of cerebral ischemia differ significantly in different centers and countries. These discrepancies are reflected by the differences in
guideline recommendations of major stroke societies. Our narrative review aims to shed light on the different recommendations in
guideline-statements of stroke societies and to give an overview of the current literature concerning acute management and post-acute treatment of cervical artery dissection patients. In general, intravenous thrombolysis and mechanical thrombectomy are recommended, irrespective of stroke etiology, if administered within the label. Secondary prevention of cerebral ischemia can be achieved by antiplatelet intake or anticoagulation, with, to date, neither treatment establishing superiority over the other. Duration of antithrombotic treatment, statin use as well as optimal endovascular approach are still up for debate and need further evaluation. Additionally, it is still unknown, whether the recommendations given in any of the
guideline statements are similarly relevant in spontaneous and traumatic cervical artery dissection, as none of the stroke societies differentiates between the two.