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颅外椎动脉(VA)剥离通常表现为单侧枕-颈后部疼痛或头痛,随之出现延髓外侧或小脑缺血症状,还可发生大脑后动脉(PCA)缺血。颅外 VA 剥离以女性多见,且以双侧为主。颅外VA 近端是最常受累的部位,病变可消退而恢复正常。颅内 VA 剥离以男性多见,并以单侧损伤为主,可延及基底动脉(BA)。常表现为蛛网膜下腔出血(SAH)或脑干缺血,一般很严重,甚至发生致命性梗塞。偶而可出现占位效应,有些患者发生双侧慢性 VA 剥离,引起反复缺血或 SAH。BA剥离较少见,也以男性为主,常发生严重致命性脑缺血,极少发生 SAH。BA 剥离可延及 BA 远端,并引起 BA 头端、小脑上动脉(SCA)和 PCA 区域的梗塞。
Extracranial vertebral artery (VA) dissection usually manifests as unilateral occipital-cervical back pain or headache followed by bulbar lateral or cerebellar ischemic symptoms and posterior cerebral artery (PCA) ischemia. Extracranial VA stripping is more common in women, and mainly bilateral. The proximal part of the extracranial VA is the site most frequently affected and the lesions subside and return to normal. Intracranial VA stripping is more common in men, and unilateral injury, can be extended to the basilar artery (BA). Often manifested as subarachnoid hemorrhage (SAH) or brainstem ischemia, the general is very serious, and even fatal infarction. Occasionally appear mass effect, some patients with bilateral chronic VA stripping, causing recurrent ischemia or SAH. BA stripping less common, but also mainly men, often fatal severe cerebral ischemia, rare occurrence of SAH. BA dissection can extend to the distal BA and cause infarction of the BA head, superior cerebellar artery (SCA) and PCA area.