用头部旋转的数字减去血管学诊断的反复过渡性意识障碍的老综合征:说明案例
Hiroki Kobayashi1, Yoshinori Kotani1, Mamoru Ogiso1
1Department of Neurosurgery, Chuno Kosei Hospital, Seki, Gifu, Japan.
Journal of neurosurgery. Case lessons
|February 17, 2025
概括
综合征是一种罕见的疾病,在特定的头部位置引起暂时失去意识,使用数字减去血管学与头部旋转来诊断. 通过手术切除笔形状体的过程,症状得到了缓解.
科学领域:
- 神经学 神经学
- 血管外科 血管外科
- 放射学 放射学是一门学科.
背景情况:
- "老综合征"是一种不常见的,反复出现的暂时性意识障碍.
- 报告的病例很少,这使得诊断具有挑战性.
研究的目的:
- 报告一种罕见的老综合征病例,该病例呈现出由特定头部位置引发的反复过渡性意识障碍.
- 为了突出数字减去血管学 (DSA) 的诊断实用性,在这种情况下用头部旋转.
主要方法:
- 一名74岁的男性患者出现了连续出现的暂时失去意识和四肢震,与向下仰望有关.
- 磁共振成像 (MRI) 结果没有确定性. 数字减去血管造影 (DSA) 用头部旋转和向左曲揭示了左侧内动脉的压缩.
- 手术干预涉及样状体过程的去除,然后是表面动脉-中脑动脉 (STA-MCA) 绕道.
主要成果:
- DSA发现左侧内动脉的血流延迟是由于形过程的压缩造成的.
- 患者的过渡性意识障碍在形过程被切除后完全消失.
- 随后进行了STA-MCA绕道,但没有出现症状的复发.
结论:
- 综合征应考虑在复发性暂时性意识障碍的差异诊断中,特别是当位置依赖时.
- 带有动态头部旋转的DSA是一种有价值的诊断工具,用于识别综合征中的血管压缩.
- 手术管理,包括 styloid 过程切除,可以有效地治疗这种情况.
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