血管内再開通療法が奏効した鈍的頚動脈損傷による急性期脳梗塞の1例

Endovascular Revascularization for Acute Ischemic Stroke Related to Blunt Carotid Injury:A Case Report

Ⅰ．緒　　言

　近年，心原性塞栓による脳前方循環主幹動脈急性閉塞に対する血管内再開通療法の有効性が証明された⁴⁾．一方，鈍的頚動脈損傷に伴い虚血性脳卒中を高率に合併することが報告されているが¹⁾，急性期血管内治療を含め，有効な対処法は明らかにされていない．今回われわれは，血管内再開通療法が奏効した鈍的頚動脈損傷による急性期脳梗塞の症例を経験したので報告する．

　Although blunt carotid artery injury is known as an important cause of ischemic stroke, the role of the endovascular treatment for acute ischemic stroke related to blunt carotid injuries remains unclear. We report the case of a patient with acute ischemic stroke secondary to blunt carotid artery injury who was treated with endovascular revascularization. A 46-year-old man suffered from sudden left-sided hemiparesis a day after a strike from a Japanese fencing staff on his right neck. 3D-CT angiography revealed tandem internal carotid artery occlusions of the cervical and C1 portions. We performed endovascular revascularization with carotid artery stenting and direct aspiration of the thrombus and achieved complete recanalization. The patient recovered almost completely. We conclude that endovascular revascularization should not be withheld from patients with acute ischemic stroke related to blunt carotid injury.