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报道因狗咬伤头、颈部后发生卒中的1例50岁健康男性。入院时,神经病学检查示左侧Babinski’s阳性,左侧肢体弛缓性瘫痪,左面部下垂。颈椎放射学和头部CT扫描正常。动脉造影证实,其右侧颈内动脉邻近颅底部内可见一内膜皮瓣摆动和一小的假性动脉瘤,同时发现右侧椎动脉和右侧大脑中动脉闭塞。入院后24小时内,病人表现为发作性意识水平降低,颅内压检查结果正常。MRI显示右侧脑梗塞。即予香兰定和物理治疗。复查颈动脉造影显示其右侧颈内动脉假性动脉瘤轻度缩小。一年后随访,其肢体功能尚未完全恢复。 讨论:由于颈内动脉靠近脑底部,故修复起来有一定困难,为防止假性动脉瘤的扩大和栓子流动,可采用颈动脉结扎,或导管气体压迫法。肝素化
A 50-year-old healthy man was reported as having a dog bite head and a stroke that followed the neck. At admission, neurological examination showed Babinski’s positive on the left, flaccid paralysis on the left limb, and sagging of the left side. Cervical radiology and CT scans of the head were normal. Arteriography confirmed that the right side of the internal carotid artery near the base of the skull showed an endothelium flap swing and a small pseudoaneurysm, also found that the right vertebral artery and right middle cerebral artery occlusion. Within 24 hours after admission, the patient showed reduced levels of episodic consciousness and normal intracranial pressure. MRI showed right cerebral infarction. Pandan and physical therapy. Review of carotid angiography showed that the right internal carotid artery pseudoaneurysm slightly reduced. Follow up after one year, the limb function has not been fully restored. Discussion: As the internal carotid artery near the bottom of the brain, it is difficult to repair it, in order to prevent the expansion of pseudoaneurysm and emboli flow, carotid artery ligation, or catheter gas compression method. Heparinization