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目的报道1例椎动脉夹层(VAD)致小脑、延髓和颈髓梗死病例。方法回顾性分析1例VAD患者的临床资料,探讨椎动脉夹层致青年脑卒中的特点。结果患者为青年女性,右侧肢体无力。体检示右侧布朗-塞卡综合征(BSS)和交叉性偏身感觉障碍。影像学检查:头颅、颈部MRI示右侧小脑、延髓急性期梗死灶。全脑DSA示右椎动脉不规则变细。颈椎动脉MRA示右椎动脉双腔改变。结论对青年患者出现BSS、交叉性偏身感觉障碍要考虑VAD,影像学检查可明确诊断。
Objective To report a case of cerebellar, medullary and cervical spinal cord infarction in one case of VAD. Methods The clinical data of one patient with VAD were retrospectively analyzed to investigate the characteristics of young stroke caused by vertebral artery dissection. Results The patients were young women, the right limb weakness. Physical examination showed right-sided Brown-Seckne syndrome (BSS) and crossbreed sensory dysfunction. Imaging examination: skull, neck MRI showed right cerebellum, medulla oblongata infarction. Whole brain DSA showed irregular right vertebral artery thinning. MRA of cervical vertebral artery shows the change of double lumen of right vertebral artery. Conclusion The incidence of BSS in young patients, crossbrain sensory dysfunction to consider VAD, imaging examination can confirm the diagnosis.