Surgical treatment of foreign body embolus in the Middle cerebral artery secondary to neck injury
Surgical treatment of foreign body embolus in the Middle cerebral artery secondary to neck injury
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颈部损伤继发大脑中动脉异物栓塞的手术治疗
DOI：
10.1080/02688697.2018.1556781
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发表时间：
2020-09
影响因子：
1.1
通讯作者：
Li Y. Z.
中科院分区：
文献类型：
--
作者：
Wang H;Ning X. J;Chen C;Lin C;Liang J. J;Li Y. Z.
摘要背景：我们报告一例大脑中动脉异物栓子的病例，并复习以前报道的类似病例。方法：1例30岁男性，颈部穿通伤后72天出现左侧肢体麻木和左手精细运动障碍1个月的病史。放射学检查显示右侧大脑中动脉(MCA)的M2部分有异物。患者接受了动脉切开和原位缝合。结果：术中发现右侧大脑中动脉M2上干分叉处有金属异物，远端血管狭窄，管壁变薄。异物周围有肉芽组织包裹。缓慢取出异物和肉芽组织，然后原位缝合。吲哚青绿血管造影术证实动脉通畅。手术三天后，患者出现左臂麻木和无力，肌力为4级。计算机断层扫描显示右侧颞叶部分梗塞。然后，使用抗痉挛药物。术后14天肌力恢复正常。结论：在亚急性期，如果CT灌注显示血流储备能力下降，可以进行手术取出动脉内异物及其周围的肉芽组织。
Abstract Background: We report a case of a foreign body embolus to the middle cerebral artery and reviewed similar cases previously reported. Methods: A 30-year-old man was seen 72 days after a penetrating neck injury with a 1-month history of numbness in the left limb and impairment of the fine movement in the left hand. Radiological examination revealed a foreign body in the M2 portion of the right middle cerebral artery (MCA). The patient received arteriotomy and in situ suturing. Results: During the operation, we found a metallic foreign body at the bifurcation of the M2 upper trunk of the right MCA, narrowed distal blood vessels and thinned vessel walls. The foreign body was surrounded by granulation tissue. Both foreign body and granulation tissue were removed slowly followed by in situ suturing. Indocyanine green angiography confirmed arterial patency. Three days after the surgery, the patient developed numbness and weakness in the left arm, with a muscle strength of grade 4. Computed tomography showed partial infarction in the right temporal lobe. Then, antispasmodic drugs were used. Muscle strength recovered by 14 days after the operation. Conclusions: In the subacute stage, surgery can be conducted to remove intra-arterial foreign bodies along with their surrounding granulation tissue if computed tomography perfusion suggests a decreased blood flow reserve capacity.
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影响因子：
1.9
作者：
T. Kuroiwa;H. Tanabe;D. Ogawa;T. Ohta
通讯作者：
T. Kuroiwa;H. Tanabe;D. Ogawa;T. Ohta
影响因子：
3.8
作者：
Farid Abdo;Malek G. Massad;Michel S. Slim;Meheddine Fahl;Maurice I. Saba;Faysal Najjar;George Saad
通讯作者：
Farid Abdo;Malek G. Massad;Michel S. Slim;Meheddine Fahl;Maurice I. Saba;Faysal Najjar;George Saad
DOI：
10.1097/00005373-198008000-00012
发表时间：
1980-08
期刊：
The Journal of trauma
影响因子：
--
作者：
Reines Hd;L. Dill;S. Saad;Hungerford Gd
通讯作者：
Reines Hd;L. Dill;S. Saad;Hungerford Gd
影响因子：
1.1
作者：
P. Haninec;L. Houšťava;J. Klener
通讯作者：
P. Haninec;L. Houšťava;J. Klener
DOI：
10.1097/00005373-197303000-00013
发表时间：
1973-03
期刊：
The Journal of trauma
影响因子：
--
作者：
MAJOR JOHN P. Kapp;Ltc Isaac Gielchinsky;MAJOR RICHARD Jelsma
通讯作者：
MAJOR JOHN P. Kapp;Ltc Isaac Gielchinsky;MAJOR RICHARD Jelsma