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椎动脉和颈动脉夹层分离可表现出极不相同的症状体征,以致早期识别困难。报道1例自发性椎动脉夹层分离患者,病初即酷似心肌梗塞。男性,46岁。7天前发生严重的左上肢间歇性疼痛,2dh 内消失。无外伤史。入院当天疼痛复发,伴眩晕和周身无力。病人呈病容,大汗,血压21.3/13.3kPa。右位相轻度自发性眼震及含有旋转成分的注视依赖性水平性眼震,向右比向左注视时明显。心电图示前侧壁 ST 段抬高,提示心肌缺血并持续数日。多次心肌酶检查未升高。入院5h 后发生延髓性构音
Separation of the vertebral artery and carotid artery dissection can show very different symptoms and signs, resulting in early identification difficulties. Reported in 1 cases of spontaneous dissection of vertebral artery dissection patients, the beginning of the disease is exactly like myocardial infarction. Male, 46 years old. Severe left upper limb intermittent pain occurred 7 days earlier and disappeared within 2 days. No history of trauma. On the day of admission pain recurrence, with dizziness and whole body weakness. The patient was sick, sweating, blood pressure 21.3 / 13.3kPa. Right phase slightly spontaneous nystagmus and rotation-dependent gaze-dependent horizontal nystagmus, right than left when the obvious. ECG front ST segment elevation, suggesting myocardial ischemia and lasted several days. Multiple myocardial enzyme tests did not increase. Medullary structural articulation occurred 5h after admission