2011, nr. 1 - Academia de Ştiinţe a Moldovei
2011, nr. 1 - Academia de Ştiinţe a Moldovei
2011, nr. 1 - Academia de Ştiinţe a Moldovei
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<strong>Ştiinţe</strong> Medicale<br />
Bibliografi e<br />
1. Beletsky V., Nadareishvili Z., Lynch J., Shuaib A.,<br />
Woolfen<strong>de</strong>n A., Norris J.W.<br />
Cervical arterial dissection: time for a therapeutic trial?<br />
Stroke, <strong>de</strong>c. 2003; 34(12):2856-2860.<br />
2. Norris J.W., Beletsky V. Sud<strong>de</strong>n neck movement<br />
and cervical artery dissection. Th e Canadian Stroke Consortium.<br />
CMAJ, july, 11 2000; 163(1):38-40.<br />
3. Rubinstein S.M., Peer<strong>de</strong>man S.M, van Tul<strong>de</strong>r<br />
M.W. A systematic review of the risk factors for cervical artery<br />
dissection. Stroke, july 2005; 36(7): 1575 – 1580.<br />
4. Saeed A.B., Shuaib A., Al-Sulaiti G. Vertebral artery<br />
dissection: warning symptoms, clinical features and<br />
prognosis in 26 patients. Can. J. Neurol. Sci., nov. 2000;<br />
27(4):292-296.<br />
5. Gonzales-Portillo F., Bruno A., Biller J. Outcome<br />
of extracranial cervicocephalic arterial dissections: A follow-up<br />
study. Neurol. Res., 2002; 24(4):395-398.<br />
6. Caplan L.R., Zarins C.K., Hemmati M. Spontaneous<br />
dissection of the extracranial vertebral arteries. Stroke,<br />
1985; 16:1030-1037.<br />
7. Lee V.H., Brown R.D., Mandrekar J.N., Mokri B.<br />
Inci<strong>de</strong>nce and outcome of cervical artery dissection: a population-based<br />
study. Neurology, 2006; 67: 1809–1812.<br />
8. Kim Y.K., Schulman S. Cervical artery dissection:<br />
pathology, epi<strong>de</strong>miology and management. Th romb. Res.,<br />
(april, 2009, 123 (6): 810–821.<br />
9. Campos-Herrera C.R., Scaff M., Yamamoto F.I.,<br />
Conforto A.B. Spontaneous cervical artery dissection: an update<br />
on clinical and diagnostic aspects. Arq. Neuropsiquiatr,<br />
2008, 66 (4): 922–927.<br />
10. Debette S., Markus H.S. Th e genetics of cervical artery<br />
dissection: a systematic review. Stroke, june, 2009, 40<br />
(6): e459–466.<br />
11. Debette S., Leys D. Cervical-artery dissections: predisposing<br />
factors, diagnosis, and outcome. Lancet, Neurol., 8<br />
july 2009, 7: 668–678.<br />
12. Arnold M., Bousser M.G. Clinical manifestations<br />
of vertebral artery dissection. Front. Neurol. Neurosci, 2005;<br />
20: 77-86.<br />
13. Provenzale J.M., Sarikaya B. Comparison of test<br />
performance characteristics of MRI, MR angiography, and<br />
CT angiography in the diagnosis of carotid and vertebral<br />
artery dissection: a review of the medical literature. Am. J.<br />
Roentgenol October, 2009, 193 (4): 1167–774.<br />
Rezumat<br />
Disecţia arterei vertebrale este o cauză importantă a<br />
acci<strong>de</strong>ntului vascular cerebral la pacienţii tineri. Aceasta<br />
poate fi spontană sau traumatică și poate conduce la diferite<br />
simptome clinice.<br />
Am <strong>de</strong>scris un caz clinic, al pacientului C. <strong>de</strong> 38 <strong>de</strong><br />
ani, care nu a suportat recent o traumă sau alt eveniment<br />
<strong>de</strong>clanșator, <strong>de</strong>butul maladiei fi ind acut cu <strong>de</strong>zechilibru,<br />
dizartrie, disfagie, parestezii în hemicorpul stâng, cefalee și<br />
dismetrie. Examenul medical a obiectivizat disecția arterei<br />
vertebrale drepte, AVC ischemic în sistemul vertebrobazilar,<br />
sindrom bulbar, hemipareză pe dreapta și tulburări cerebeloase.<br />
29<br />
Summary<br />
Vertebral Artery Dissection in Young Adults – Case<br />
Report and Review of the Literature Vertebral artery dissection<br />
is a important cause of stroke in young patients. It<br />
may be spontaneous or traumatic and can lead to various<br />
clinical symptoms.<br />
We <strong>de</strong>scribe a case of 38-year-old man, with no preceding<br />
trauma or apparent inciting event, presented with the<br />
acute onset of imbalance, dysarthria, left -si<strong>de</strong>d paresthesias,<br />
headache, dysphagia, and dysmetria. Workup revealed<br />
a right vertebral artery dissection, ischemic stroke in the<br />
vertebro-basilar system, bulbar syndrome, right hemiparesis<br />
and cerebellar disor<strong>de</strong>rs.<br />
Pезюме<br />
Диссекция позвоночной артерии является важной<br />
причиной нарушения мозгового кровообращения<br />
(инсульта) у молодых пациентов. Она может быть<br />
спонтанной или травматической, и приводят к разным<br />
клиническим симптомам.<br />
Описан клинический случай пациента К., 38 лет,<br />
который не перенес недавно травму и не имел другой<br />
какой-либо провоцирующий фактор. Начало заболевания<br />
проявилось остро нарушением равновесия, дизартрией,<br />
дисфагией, парестезиями в левой половине<br />
тела, головной болью и дисметрией. Медицинские обследования<br />
объектизировали диссекцию правой вертебральной<br />
артерии, ОНМК (ишемический инсульт)<br />
в вертебро-базилярном бассейне, бульбарные нарушения,<br />
правосторонний гемипарез и мозжечковые расстройства.<br />
REZULTATELE TESTULUI<br />
CU ÎNCLINARE LA PACIENŢII<br />
CU MIGRENĂ ASOCIATĂ CU SINCOPĂ<br />
_______________________________________<br />
Galina Corcea, medic-neurolog,<br />
IMSP Institutul <strong>de</strong> Neurologie și<br />
Neurochirurugie<br />
Introducere. Migrena ca entitate nozologică este<br />
inclusă în grupa cefaleelor primare, având ca substrat<br />
patogenic fundamental fenomenul <strong>de</strong> activare trigeminovasculară.<br />
Totuși, rezultatele cercetărilor privind<br />
mecanismele patogenice ale migrenei sunt controversate.<br />
Multe dintre simptomele ce însoţesc atacul migrenos<br />
sau pot apărea și interictal (fotofobie, greţuri,<br />
vome sau disfuncţie gastrochinetică, variaţii ale TA,<br />
palpitaţii cardiace, transpiraţie, piloerecţie, micţiuni<br />
frecvente ș.a.) sunt <strong>de</strong> geneză vegetativă sugerând implicarea<br />
Sistemului Nervos Autonom (SNA) în meca-