小脳脳幹梗塞を呈した椎骨動脈解離の1例

概要

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Dissection of the vertebral artery has been described after cervical trauma received during chiropractic manipulations, yoga exercise and playing sports and a variety of seemingly mundane activities. We report an unusual cause of vertebral artery dissection. A 32-year-old man had abrupt vertigo, tinnitus of left ear and facial dysesthesia on the left side rotating his neck. He had the habit of rotating his neck to pop it. MRI of the head showed infarctions of the bilateral cerebellar hemisphere and left cerebellar peduncle and high signal replacing the normal flow void of the vertebral artery. Cerebral angiography showed irregular stenosis and pseudoaneurysm of the left vertebral artery at the Cl-2 level. Aspirin therapy was begun. Just over 2 months following the onset, angiography revealed a return to almost normal caliber of the left vertebral artery at Cl-2 level and complete obliteration of the pseudoaneurysm. Granting that the patient may have had unrecognized trauma, we should consider the possibility of dissection, because dissection of the vertebral artery at the Cl-C2 level with neck rotation may occur with frightening ease.
日本脳卒中の外科学会の論文
2001-07-31