軽傷交通外傷後,遅発性に脳梗塞を発症した頭蓋外頚部内頚動脈解離の1例

DOI

書誌事項

タイトル別名
  • A case report of delayed cerebral infarction due to carotid artery dissection after a traffic accident without craniocervical trauma

この論文をさがす

抄録

<p>Blunt cerebrovascular injury (BCVI) is rare, accounting for 1–2% of all blunt injuries, but 10–20% may develop a stroke, resulting in morbidity or mortality. Although screening criteria for diagnosis are indicated, stroke due to BCVI may occur even in cases with minor injuries that meet no criteria, and early diagnosis before the onset of a stroke is difficult. Traffic accidents are the most common cause of trauma, and 60–80% of traumatic internal carotid artery occlusion cases occur within 24 hours after the injury. Still, in rare cases, it occurs later than seven days. We experienced a tandem occlusion of the extracranial carotid artery and middle cerebral artery due to the internal carotid artery dissection 23 days after a minor traffic accident without head or neck trauma. Mechanical thrombectomy combined with intravenous administration of recombinant tissue plasminogen activator was performed, and good recanalization was obtained. Carotid artery stenting was suc­cessfully added for the residual pseudoaneurysm of the internal carotid artery seven days after the initial treatment. The patient recovered well and was transferred to another hospital for rehabilitation.</p><p>BCVI sometimes occurs even if minor injuries do not meet the previously proposed screening criteria and rarely cause a cerebral infarction more than seven days after the initial injury. Some reports recommend more comprehensive cervical vessel screening in minor trauma patients. As a treatment, especially in patients with residual stenosis or pseudoaneurysm, endovascular stenting is effective in addition to medical therapy for stroke prevention.</p>

収録刊行物

  • 神経外傷

    神経外傷 46 (1), 26-30, 2023-06-30

    一般社団法人 日本脳神経外傷学会

詳細情報 詳細情報について

問題の指摘

ページトップへ