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脑栓塞通常是由心脏或颈部动脉病变所引起。然而,也可能并发于椎动脉起始部的锁骨下动脉病变。有人证明是直接地由左锁骨下动脉起始部的主动脉斑所引起。本文报告5例这种情况的脑栓塞,并指出了发病机制和临床处理对病情的影响。 5例中3男2女。年龄21～50岁,平均35岁。5例均有明显的一侧肢体无力、言语困难、视力减退伴有同向偏盲和锥体束征等。其中3例发病前有左或右上肢疼痛、麻木、无力等症状;3例有类似暂时性脑缺血发作史;4例左或右锁骨上窝有搏动性肿块及/或血管杂音。胸部X线检查:3例有一侧或双侧颈肋,1例有主动脉峡部动脉瘤。多普勒(Doppler)超声检查及/或选择性动脉造影和X线检查,分别证明
Cerebral embolism is usually caused by heart or neck artery disease. However, subclavian artery lesions may also occur at the beginning of the vertebral artery. It has been shown to be caused directly by aortic plaque at the beginning of the left subclavian artery. This article reports five cases of cerebral embolism in this condition and points out the impact of the pathogenesis and clinical management on the condition. 5 males and 2 females. Age 21 to 50 years old, average 35 years old. All 5 patients had obvious weakness of one limb, speech difficulties, vision loss accompanied by hemianopia and pyramidal tract signs. Three of them had symptoms of left or right upper extremity pain, numbness, weakness and other symptoms before onset; 3 had a history of transient ischemic attack; 4 had pulsed lumps and / or vascular murmurs in the left or right supraclavicular fossa. Chest X-ray examination: 3 cases had one or both sides of the rib cage, 1 case of aortic isthmus aneurysm. Doppler ultrasonography and / or selective arteriography and X-ray examinations, respectively, demonstrated