Pourazowe uszkodzenie tętnic domózgowych ze szczególnym uwzględnieniem tętnic kręgowych: charakterystyka procesu diagnostyczno-terapeutycznego

• Authors: Marcin Rogoziewicz , Anna Borkowska-Konieczna , Wojciech Kozubski

Title variants

EN

Traumatic damage of cervical arteries with a particular consideration of vertebral arteries: characteristics of diagnostic therapeutic process

• Languages of publication: PL

Abstracts

PL

Rozwarstwienie tętnic kręgowych jest chorobą występującą rzadko, niemniej wiążącą się z poważnymi konsekwen­cjami. Szacuje się, że jest to jedna z najczęstszych przyczyn udaru niedokrwiennego mózgu u osób przed 45. rokiem życia. Rozpoznanie uszkodzenia tętnic kręgowych jest łatwiejsze, gdy u chorego widoczne są ślady po doznanym urazie szyi (np. rana cięta). Rozwarstwienie naczynia może być również wynikiem tzw. urazów tępych w mecha­nizmie „bicza”, powstałych np. podczas kolizji drogowej lub w czasie działania tłoczni brzusznej. Początkowo dochodzi do pęknięcia błony wewnętrznej tętnicy, a następnie jej odwarstwienia i tworzenia skrzepliny – zwężającej lub zamykającej światło naczynia, czego następstwami są niedokrwienie mózgu i kliniczne objawy neurologiczne. Tworzenie skrzepliny w tzw. fałszywym świetle tętnicy może być także źródłem materiału zatorowego. W przypadku podejrzenia rozwarstwienia tętnicy kręgowej ważne są monitorowanie stanu neurologicznego pacjenta i wnikliwa diagnostyka naczyniowa. Celem pracy było przedstawienie aktualnego stanu wiedzy dotyczącej przyczyn uszko­dzenia tętnic kręgowych, charakterystycznych dla jednostki objawów, możliwości diagnostycznych i sposobów leczenia oraz rokowań. Uważa się, że wczesne zdiagnozowanie rozwarstwienia tętnicy i zastosowanie leczenia zwiększa szansę na przeżycie, a chory unika trwałych powikłań neurologicznych.

EN

Vertebral artery dissection is a disease that occurs rarely, but binding, however, with serious consequences. It is esti­mated that this is one of the most common causes of ischemic stroke in people under 45 years of age. The diagnosis of vertebral artery damage is easier when the patient shows signs of the occurrence of neck injury (e.g. cut injuries). However, the dissection of the vessel may also be a result of the so-called blunt trauma to the mechanism of “whip” for example, during an accident or during application of the abdominal pressure. Initially there is a rupture of the arterial intima, followed by the detachment and the formation of thrombus. This leads to the formation of throm­bus or narrowing the lumen closure resulting in a clinical cerebral ischemia and neurological symptoms. Thrombus formation in the so-called misrepresent the artery can also be a source of embolic material. In case of suspicion of vertebral artery dissection are important: monitoring the neurological status of the patient and careful diagnosis of vascular. The aim of this study was to present the current state of knowledge about the causes of damage to the ver­tebral arteries, characteristic of the symptoms, diagnostic options and treatments and negotiations. It is believed that early diagnosis of arterial dissection and application of treatment increases the chance of survival and the pa­tient avoid permanent neurological complications.

Keywords

EN

cervical and vertebral dissection; neck injury; rozwarstwienie tętnic domózgowych; skrzeplina; stroke; thrombus; udar mózgu; ultrasonografia; ultrasonography; uraz szyi

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Aktualności Neurologiczne
• Year: 2013
• Volume: 13
• Issue: 4
• Pages: 279–286

Contributors

author

Marcin Rogoziewicz

• Oddział Neurologiczny z Pododdziałem Leczenia Udarów Mózgu, Szpital Specjalistyczny im. St. Staszica w Pile

author

Anna Borkowska-Konieczna

• Oddział Neurologiczny, 107. Szpital Wojskowy z Polikliniką w Wałczu

author

Wojciech Kozubski

• Katedra i Klinika Neurologii, Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu

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• Document Type: article