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目的:报道1例因外伤性颈内动脉闭塞致急性缺血性卒中患者的临床诊治经过,并对相关文献进行复习。方法:报道1例因外伤性颈内动脉闭塞致急性缺血性卒中患者的临床诊疗经过。同时,结合相关文献对外伤性颈内动脉闭塞的临床特征和诊治进展进行复习。结果:1例外伤性颈内动脉闭塞患者发生急性缺血性卒中而接受静脉溶栓治疗。治疗2周后,患者右侧肢体功能恢复,仅遗留部分运动性失语;美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分为2分。治疗6周后,复查颈动脉计算机断层摄影血管造影(computed tomography angiography,CTA),提示左侧颈总动脉近段狭窄,其远端颈总动脉闭塞直至颈总动脉分叉处。于是行左侧颈动脉内膜剥脱术+取栓术+颈动脉支架成形术。术后随访,患者预后良好。结论:对于外伤性颈内动脉闭塞致急性缺血性卒中的患者,可基于指南推荐,进行个体化治疗。在溶栓时间窗内及时进行静脉溶栓治疗,可以改善患者的预后。
OBJECTIVE: To report the clinical diagnosis and treatment of 1 case of acute ischemic stroke caused by traumatic carotid artery occlusion and to review the relevant literature. Methods: One case of acute ischemic stroke induced by traumatic carotid artery occlusion was reported. At the same time, combined with relevant literature on the clinical features of traumatic carotid artery occlusion and diagnosis and treatment progress review. Results: One case of traumatic carotid artery occlusion was treated with intravenous thrombolysis due to acute ischemic stroke. After 2 weeks of treatment, the function of the right limb recovered, leaving only part of motor aphasia; the National Institutes of Health Stroke Scale (NIHSS) score of 2 points. After 6 weeks of treatment, the carotid artery computed tomography angiography (CTA) was reviewed to show that the left common carotid artery was stenosed proximally and the distal common carotid artery occluded until the common carotid artery bifurcation. Then line left carotid endarterectomy + thrombectomy + carotid stenting. Postoperative follow-up, patients with good prognosis. Conclusion: Patients with acute ischemic stroke with traumatic intercarotid artery occlusion may be treated individually based on the recommendations of the guidelines. Intravenous thrombolysis in a timely thrombolysis time window can improve patient outcomes.