carotid steal syndrome
Introduction
Introduction to carotid steal syndrome Carotid steal syndrome refers to when the internal carotid artery is occluded, it can cause the contralateral internal carotid artery blood to flow into the affected side through the anterior communicating artery, or the vertebral-basal artery blood flows through the ipsilateral posterior communicating artery into the neck. Arteries, which can produce limb paralysis or sensory disturbances on the same side of the occluded blood vessels, or clinical manifestations of vertebral-basal arterial insufficiency, such as hemiplegia, partial sensory disturbances, and aphasia. The treatment of this disease may be based on the specific circumstances of the choice of endarterectomy, vascular bypass (bridge) surgery, intracranial extracranial anastomosis, etc., to improve the condition of insufficient blood supply. This disease is contraindicated with vasodilators and antihypertensive drugs, which can often lead to increased blood stealing. In addition, it can be combined with symptomatic treatment. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: atherosclerosis
Cause
Causes of carotid steal syndrome
When one side of the internal carotid artery is occluded, the blood flow of the internal carotid artery passes through the anterior communicating artery into the affected side, causing the ischemic manifestation of the internal carotid artery system; the blood flow of the vertebral-basal artery can also flow through the posterior communicating artery. The internal carotid artery produces an ischemic manifestation of the vertebral-basal artery system.
Prevention
Prevention of carotid steal syndrome
The treatment of this disease may be based on the specific circumstances of the choice of endarterectomy, vascular bypass (bridge) surgery, intracranial extracranial anastomosis, etc., to improve the condition of insufficient blood supply. This disease is contraindicated with vasodilators and antihypertensive drugs, which often lead to aggravation of "stealing blood". In addition, it can be combined with symptomatic treatment. Early detection, early diagnosis, early treatment is the key.
Complication
Carotid blood stasis syndrome complications Complications atherosclerosis
May be complicated by atherosclerosis and so on.
Symptom
Carotid blood stasis syndrome symptoms Common symptoms Limb numbness contralateral limb hemiplegia vascular murmur carotid pulsation weakened or disappeared forgetful aphasia
Clinical manifestations of recurrent intracervical system TIA, such as lesion side-pass black sputum, contralateral reversible hemiparesis, limb numbness and aphasia, etc., internal carotid artery pulsation weakened or disappeared, and can hear vascular murmur.
Examine
Examination of carotid steal syndrome
Clinical manifestations of recurrent internal carotid artery system TIA, such as lesion side-pass black sputum, contralateral reversible hemiparesis, limb numbness and aphasia; internal carotid artery pulsation weakened or disappeared, and can hear vascular murmur. Blood and CSF routine examinations generally have no specific performance
1. Transcranial Doppler Ultrasound (TCD) detection of cervical vascular and blood flow suspects should be tested on the affected side of the beam, can detect changes in the reverse blood flow of the vertebral artery (Huang Yining et al., 1997)
2. Digital subtraction angiography (DSA) focuses on the observation of vessels such as the subclavian artery and common carotid artery on both sides of the aortic arch. If the subclavian or brachiocephalic trunk is found to be dry, the proximal segment of the vertebral artery is severely stenotic (mostly 85% of the lumen) or almost occluded, and even the contrast agent is seen to rise up to the basilar artery through the contralateral vertebral artery. Downward (reverse flow) to the distal heart of the affected subclavian artery is more diagnosed
Diagnosis
Diagnosis and identification of carotid steal syndrome
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
Differentiation from subclavian steal syndrome and vertebrobasilar syndrome:
1. Subclavian artery stealing syndrome: When one side of the subclavian artery or the innominate artery is significantly narrowed and occluded at the proximal end of the vertebral artery, if the upper limb is active, the blood flow of the affected side and the contralateral vertebral artery The affected side artery flows back into the subclavian artery and supplies the affected upper limb, thereby causing symptoms of vertebrobasilar insufficiency. The clinical manifestations include dizziness, blurred vision, diplopia, ataxia, and other symptoms of brain stem, occipital lobe and cerebellum or limb hemiparesis and sensory disturbance after upper limb movement.
2, vertebral-basal artery stealing syndrome: when the vertebral-basal artery is obviously narrowed or occluded, the blood of the internal carotid artery system flows back into the vertebral-basal artery system through the posterior communicating artery, which can produce symptoms of insufficient blood supply to one side of the cerebral hemisphere. This type is less common.
Clinical manifestations of recurrent internal carotid artery system TIA, such as lesion side-pass black sputum, contralateral reversible hemiparesis, limb numbness and aphasia; internal carotid artery pulsation weakened or disappeared, and can hear vascular murmur.
