背景:脊髓梗死是一种罕见的神经系统疾病。我们介绍了一例由左椎动脉(VA)起源支架置入引起的高颈索梗塞。脊髓梗塞的发生率很低,它必须与许多其他疾病区分开来。诊断主要基于影像学,临床症状,和历史。目前,脊髓梗塞没有集中治疗。溶栓,大剂量糖皮质激素休克,管扩张,以促进循环,在疾病的早期给予营养神经营养药物都可以帮助减缓疾病的进展。在病因上没有达成一致,诊断,或这些人的治疗选择。
方法:2023年10月7日,一名81岁的男子因反复发作的胸闷和疼痛而入院,持续超过2年零1个月。入院时的脑血管造影显示右VA明显阻塞,左椎动脉起源狭窄。入院后六天,在局部麻醉下进行药物洗脱支架置入手术,通过股动脉打开左VA起点.按照程序,患者在所有4个肢体中都出现了肌肉力量的进行性丧失和颈3脊髓以下的截瘫。手术后一周,病人出院了。手术后,1周后患者出院.手术后,患者的症状持续了一个月。
结论:当手术后出现颈部不适和肢体无力并伴有进行性进展时,需要高度关注高颈索梗死。在临床上,由于VA起源的狭窄而置入支架后,高颈索梗塞的并发症并不常见。通过及时的诊断和护理可以改善患者的预后。
BACKGROUND: Spinal cord
infarction is an uncommon nervous system disorder. We present a
case of high cervical cord
infarction caused by stenting of the origin of the left vertebral artery (VA). The incidence of spinal cord
infarction is minimal, and it must be distinguished from a number of other disorders. The diagnosis is primarily based on imaging, clinical symptoms, and history. Currently, there is no focused treatment for spinal cord
infarction. Thrombolysis, high-dose glucocorticoid shocks, tube dilatation to promote circulation, and nutritional neurotropic medicines given early in the course of the disease can all help to slow the disease\'s progression. There is no agreement on the etiology, diagnosis, or therapy options for these people.
METHODS: On October 7, 2023, an 81-year-old man was admitted to the hospital primarily for recurrent chest tightness and pain that had persisted for more than 2 years and 1 month. Cerebral angiography upon admission revealed significant blockage of the right VA and stenosis of the left vertebral arterial origin. Six days following admission, a drug-eluting stenting procedure was carried out under local anesthesia to open the left VA origin via the femoral artery. Following the procedure, the patient experienced a progressive loss of muscle strength in all 4 limbs and paraplegia below the cervical 3 spinal cord. One week following the procedure, the patient was released from the hospital. After the procedure, the patient was released 1 week later. After the procedure, the patient\'s symptoms persisted for a month.
CONCLUSIONS: High awareness for high cervical cord infarction is required when neck discomfort and limb weakness with progressive progression arises after surgery. Complications of high cervical cord
infarction following stenting for stenosis of VA origin are uncommon in clinical settings. Patients\' prognoses can be improved by prompt diagnosis and care.