#Extraordinary cases ##健康科普大赛 #
Cao Li (pseudonym), 39, recently suffered from shoulder and neck discomfort, and after a neck massage, he suddenly appeared weak on the right side and was inarticulated and rushed to Changsha Central Hospital (Changsha Central Hospital Affiliated to the University of South China), where he was diagnosed with "acute cerebral infarction, left internal carotid artery thrombosis, and left internal carotid artery dissection".
October 29 is the 16th "World Stroke Day", doctors remind: In recent years, the department of neurology of the hospital has received many patients with carotid artery dissection caused by improper neck massage, and the public should pay attention to it.
Cao Li introduced that he is 39 years old this year, there is no major problem with his body in the past, three days ago due to shoulder and neck discomfort, he went to a blind massage parlor to do a neck massage, and after the massage, he felt that the shoulder and neck were much easier.
Three days later, Cao Li suddenly appeared to have weakness in his right limb and was sent to the emergency department of Changsha Central Hospital (Changsha Central Hospital affiliated to the University of South China) by his family.
After a series of evaluations and examinations, he was diagnosed with "acute cerebral infarction and left internal carotid artery thrombosis".
After the emergency department opened the green channel for intravenous thrombolysis, the symptoms improved slightly, and the weakness and slurred speech of the right limb were significantly improved, but after a few minutes, the condition worsened, and the right limb was completely paralyzed.
After an emergency total cerebral angiography under local anesthesia of the neurology intervention team, the culprit of the patient's "stroke" was found: the left internal carotid artery dissection.
The left internal carotid artery vascular recanalization is performed in time to turn the patient around.
After a period of hospitalization, Mr. Cao was able to walk under the support and gradually recovered.
【Nurses instructing patients to do rehabilitation exercises】
Why did Mr. Cao have a stroke at a young age?
Stroke is known to occur in middle-aged and elderly people, and common risk factors include: hypertension, hyperlipidemia, smoking, diabetes, obesity, atrial fibrillation, etc.
"In recent years, among young people under the age of 45, the proportion of ischemic stroke caused by carotid artery dissection can be as high as 8%-25%, and the majority of young people deserve attention." He Guohua, chief physician of the Department of Neurology, introduced that carotid artery dissection refers to the "cracking" of the lining of the carotid artery wall, causing blood to accumulate in the blood vessel wall.
The formation of a hematoma on the vascular wall causes normal vascular narrowing to cause a decrease or disappearance of blood flow to the distal brain tissue, and may lead to local thrombosis and detachment to the distal end, triggering stroke.
【Internal carotid artery dissection】
In addition to some congenital factors such as vascular fibrous dysplasia disease, Moyamoya disease, etc. are relatively easy to cause arterial dissection, normal carotid arteries can also tear the lining of the vascular wall under the strong external force, triggering carotid artery dissection.
Commonly seen in neck massage and tuina, ice skating, badminton, tennis, yoga practice, roller coaster rides, and even sudden turnbacks.
He Guohua reminded that in recent years, due to the rise of massage, which is a relaxing and decompressive method, the neurology department of the hospital can receive a number of cases of carotid artery dissection patients caused by improper neck massage every year.
Commonly presents with localized pain with symptoms of focal neurologic deficits. Clinical symptoms are related to the blood vessel site of the lesion, which can cause limb weakness, slurred speech, blackness/vision loss, crooked corners of the mouth, diplopia, etc., and can cause coma and even life-threatening in severe cases.
He Guohua stressed that the public should seek medical treatment in time when they have early related symptoms, so as not to miss the best time for treatment.
(Editing Rainbow.) Some of the image sources of the network, invasion and deletion)
Hunan Medical Chat Special Author: Changsha Central Hospital (Changsha Central Hospital Affiliated to the University of South China) Wang Zhen, Yi Haibo, Zhu Wenqing
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