[椎动脉剖析在部脊椎创伤期间,两个病例报告]
Zsolt Csaba Oláh1,2,3, Dávid Nagy2, Attila Sas4
1BAZ Megyei Központi Kórház és Egyetemi Oktató Kórház, Intervenciós Radiológia Osztály, Miskolc.
Ideggyogyaszati szemle
|July 31, 2024
概括
严重的椎脊椎损伤可能导致脊椎动脉解剖或阻塞,可能导致神经损伤. 及时诊断和治疗,包括内血管程序,对于管理这些关键的血管并发症至关重要.
科学领域:
- 神经学 神经学
- 血管外科 血管外科
- 创伤外科 手术 创伤外科
背景情况:
- 严重的椎脊髓损伤,骨折,突起或脱会导致脊椎动脉解剖或闭塞的风险为20-40%.
- 脊椎动脉损伤可能是无症状的,或导致严重的神经缺陷,除了宫骨髓病和神经根压缩.
- 原因包括直接的创伤 (刺伤,枪击) 和与椎脊柱不稳定相关的间接机制.
研究的目的:
- 报告两起脊椎动脉损伤的病例,这是宫创伤的次要原因.
- 突出诊断和治疗方法来管理椎动脉解剖和闭塞在椎脊椎损伤的背景下.
主要方法:
- 计算机断层扫描血管图 (CTA) 用于初步诊断.
- 数字减去血管学 (DSA) 用于详细的血管评估.
- 神经干预程序,包括母血管封闭,作为神经外科手术前的干预.
主要成果:
- 案例1:完整的C.VI脱导致单边的2段脊椎动脉剖析-封闭.
- 案例2:刺伤导致脊椎动脉直接压缩和剖析.
- 两位患者都没有出现与脊椎动脉封闭有关的神经症状.
- 在神经外科手术之前,在两种情况下都成功进行了母血管封闭.
结论:
- 脊椎动脉解剖和闭塞是与严重的宫创伤相关的重大风险.
- CTA是诊断的首选成像方式.
- 内血管治疗,如母血管封闭,可以是开放手术前的有效策略,即使是在无症状的情况下.
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