脑动脉夹层的研究进展

Research progress of cerebral artery dissection

关键词:  脑动脉夹层  流行病学特点  危险因素  临床表现

Key words:  cerebral artery dissection  epidemiological characteristics  risk factors  clinical manifestations

摘要:

脑动脉夹层（cerebral artery dissection，CAD）是中青年人缺血性卒中的原因之一。根据受影响的动脉，CAD可分为颅内动脉夹层（intracranial artery dissection，IAD）及颈部动脉夹层（cervical artery dissection，CeAD）。CeAD可以分为椎动脉夹层（vertebral artery dissection，VAD）及颈内动脉夹层（internal carotid artery aissection，ICAD）。患者可能无症状，可能表现为头痛、颈痛、缺血性卒中、蛛网膜下腔出血（subarachnoid hemorrhage，SAH）等症状。在欧洲人群中，IAD较CeAD少见，但在儿童和亚洲人群中IAD常见。CAD的危险因素和发病机制不明确，影像学标准不足，临床诊断困难，目前主要通过DSA确诊。CAD的治疗是经验性的，需根据患者的适应证适当选择，目前以抗血栓治疗为主。

Abstract:

Cerebral artery dissection (CAD) is considered to be one of the causes of ischemic stroke in young and middle-aged people. CAD is divided into intracranial artery dissection (IAD) and cervical artery dissection (CeAD) according to the location of the affected artery. CeAD can be divided into vertebral artery dissection (VAD) and internal carotid artery dissection (ICAD). Patients may be asymptomatic, or present with headache, neck pain, ischemic stroke, and subarachnoid hemorrhage (SAH). Although intracranial artery dissection is less common in European populations than cervical artery dissection, it is reported that intracranial artery dissection is more common in children and Asian populations. Risk factors and mechanisms remain unclear. Radiological criteria are still insufficient, and clinical diagnosis of CAD is difficult, the diagnosis is mainly made through DSA now. The treatment of cerebral artery dissection is experiential and should be based on the specific indications of patients to choose the appropriate treatment, antithrombotic therapy is the main choice.