持续的头痛没有神经缺陷来自自发的脊椎动脉剖析
Alec Ajhar1, Rohith Kothakapu2, Mitchell Arends1
1Emergency Medicine Resident at Madigan Army Medical Center, 9040A Jackson Avenue Joint Base Lewis-McChord, WA 98431-1100, USA.
The American journal of emergency medicine
|April 24, 2024
概括
脊椎动脉解剖可以导致中风,即使没有创伤或神经缺陷. 紧急医生应该考虑这种诊断,以新的头痛和先前的头.
科学领域:
- 神经学 神经学
- 紧急医疗 紧急医疗
- 血管外科 血管外科
背景情况:
- 非创伤性头痛在急诊室经常出现.
- 诊断中风的原因需要全面的差异诊断.
研究的目的:
- 突出脊椎动脉剖析作为新发头痛和先前的患者的关键诊断.
- 要强调考虑这种诊断的重要性,即使是在正常的神经学检查和没有创伤史的情况下.
主要方法:
- 一个21岁的男性患有新发作的头痛和的案例介绍.
- 诊断工作包括脑部和部的CT扫描和MRA.
- 关于脊椎动脉剖析和中风的文献综述.
主要成果:
- 这名患者被诊断为左脊椎动脉剖析,由缺血小脑中风复杂化.
- 脊椎动脉剖析虽然很少见,但患病率和死亡率很高.
- 亚急性表现的诊断挑战需要彻底的病史和敏感的考试,如HINTS考试.
结论:
- 脊椎动脉剖析应该是急诊医生在新发作头痛和先前的症状的情况下的主要考虑因素.
- 正常的神经学检查和没有创伤并不能排除脊椎动脉剖析.
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