Đặc điểm lâm sàng, hình ảnh cắt lớp vi tính và kết quả tái thông cơ học ở bệnh nhân đột quỵ nhồi máu não cấp dưới 50 tuổi do bóc tách động mạch cảnh trong=Clinical features, computed tomography and mechanical thrombectomy result in acute ischemic stroke patients under age of 50 due to internal carotid artery dissection

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Tác giả: Thị Nguyệt Lê, Văn Trường Lê, Trọng Tuyển Nguyễn, Văn Tuyến Nguyễn, Thị Ngọc Khanh Thạch, Xuân Thuỷ Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.9-16

Bộ sưu tập: Metadata

ID: 242229

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Đánh giá đặc điểm lâm sàng, hình ảnh cắt lớp vi tính sọ não (CT) và kết quả của tái thông cơ học ở bệnh nhân (BN) đột quỵ nhồi máu não (ĐQNMN) cấp do bóc tách động mạch cảnh trong. Đối tượng và phương pháp: Mô tả cắt ngang 17 BN ĐQNMN cấp do bóc tách động mạch cảnh trong (ĐMCT) được điều trị tại Khoa Đột quỵ não, Viện Thần kinh, Bệnh viện TWQĐ 108. Kết quả: Tỷ lệ BN NMN cấp bóc tách động mạch cảnh chiếm tỷ lệ 2,6% những BN NMN cấp do tắc nhánh lớn. Tuổi trung bình: 41,8±6,96 (23-48), nam: 88,2%. Yếu tố nguy cơ đột quỵ thường gặp là hút thuốc lá và rối loạn lipid máu (23,5% và 17,6%). Yếu tố nguy cơ hay gặp nhất của bóc tách động mạch cảnh liên quan đến các động tác ưỡn cổ (17,6%), phình mạch não đi kèm và migraine (11,8%). Điểm NIHSS trung bình (11,12±5,4 (5-22), ASPECTS trung bình: 8,59±1,46 (6-10). Tỷ lệ tắc tandem (52,9%). Tỷ lệ tái thông tốt (100%), không gặp trường hợp chảy máu não nội sọ. Đặt stent động mạch cảnh cấp cứu (94,1%). Tỷ lệ hồi phục tốt sau 3 tháng: 100%. Kết luận: Tái thông cơ học ở những BN NMN cấp do bóc tách động mạch cảnh trong an toàn và hiệu quả đối với những BN có chỉ định. Đặt stent trong NMN cấp do bóc tách động mạch cảnh trong là an toàn và mang lại hiệu quả tái thông tốt.To investigate clinical features, head computed tomography và mechanical thrombectomy treatment in acute ischemic stroke patients due to internal carotid artery dissection. Subject and methods: A cross-sectional descriptive study on 17 patients with acute ischemic stroke due to internal carotid dissection who underwent mechanical thrombectomy treated in the Stroke department, Institute of Neurology, 108 Military Central Hospital. Results: Internal carotid artery dissection contributes to 2,6% of all acute ischemic stroke patients with large vessel occlusion. The mean age was 41,8±6,96 (23-48), with males accounting for 88.2%. The most common risk factors for stroke were smoking and dyslipidemia (23,5% and 17,6%, respectively). The most common associated conditions with carotid dissection were extreme neck movements (17.6%), accompanying brain aneurysm, and Migraine (11.8%). The mean age and ASPECTS were 11,12±5,4 and 8,59±1,46, respectively. 59,2% of patients had tandem occlusion. Intracranial recanalization (TICI 2b, 3) was achieved in 17 patients (100%), and there was no intracranial hemorrhage. Acute stent placement was feasible for 91,4%. After 3 months, 17 patients (100%) had a favorable outcome. Conclusions: Mechanical endovascular treatment of internal carotid dissection is safe and effective with the proper indication of the patients. Acute stenting of the dissected carotid artery was safe and efficacy in recanalization.

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