The Clinical Features And Evaluate Therapy Analysis Of17Cases Of Cervicocerebral Arterial Dissection

【Objective】To describe clinical features and evaluate therapy in case with Cervico-cerebral arterial dissection (CAD).【Methods】Seventeen cases of CAD who visited FuJian Union Hospital during2009-2012were collected and retrospectively reviewed. The risk factors，clinicmanifestations， characteristic signs in imagine and outcome of therapy weresummarized and analyzed. These cases were all diagnosed by DSA or/and CTA.【Results】17cases of CAD includeds6cases of internal carotid dissection（ICD），8cases of vertebral artery dissection（VAD），2cases of basilar artery dissection and1case of carotid-vertebral dissection. These patients’average age（44.5±10.9）yearsold. In17cases，risk factors related to CAD included hypertension in4cases，Diabetes in2cases，high LDL in3cases，high Hcy in1case，Acupuncture andmoxibustion in1cases，strenuous exercise in2cases，serious cough in1cases.Clinical manifestation in16cases presented as ischemic cerebral diseases and in onecase as headache．Imagine manifestations in CAD：CTA examination on the affectedarteries，irregular narrow in7case，irregular the pipe diameter become longer in3case，double lumen and so called “string signal”in2case.DSA examination on theaffected arteries had positive outcome，irregular artery straitness in5cases，Dissectinganeurysm in3cases，“rat tail signal”in3cases，“string signal”in2cases，“flamesample signal”in2cases，contrast-media retention in1case，In6cases of ICD，2patients were treated with stnet，Plavix was used to treat ICD in one case，Plavix andAspirin was used in one case，Warfarin was used in two cases. In10Cases of VCD，Anticoagulation with heparin was used to treat VCD in four cases，followed bywarfarin until2weeks,anticoagulation with heparin and warfarin in3days thenfollowed by warfarin was used in1cases，aspirin or plavix was used in four cases，Plavix and Aspirin was used in one case. The carotid-vertebral dissection case wastreated by anticoagulation with heparin and warfarin in3days then followed bywarfarin. All patients’symptoms become better after treatment，the NIHSS gradereduced average1.95point all patients were reviewed Imagine examination after3to9months from the first treatment，the results show better curative effect.【Conclusion】1、Diagnosis of sCAD may depend on clinical manifestations andcharacteristic signs on Imagine examination，especially the DSA examination.2、 Drug treatment is the main way in CAD，and is effective treatment，how to selectdrug，Platelet aggregation inhibitors or anticoagulant therapy，depended on clinicalfeatures，individuation therapies are effective treatment in CAD．If drug treatment isnot so effective，we can conside interventional therapy.