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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >A Rare Case of Symptomatic Carotid Stenosis Caused by Mechanical Stimulation by Thyroid Cartilage and Frequent Swimming
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A Rare Case of Symptomatic Carotid Stenosis Caused by Mechanical Stimulation by Thyroid Cartilage and Frequent Swimming

机译：甲状腺软骨机械刺激和频繁游泳引起的罕见颈动脉狭窄的罕见案例

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Background: Bony structures around the carotid artery such as the styloid process and hyoid bone can cause dissection, compression, plaque formation, and plaque rupture of the carotid artery. To the best of our knowledge, this case is the first finding of thyroid cartilage being the cause of a lesion corresponding to adjacent common carotid artery (CCA) atherosclerosis. Case Description: A 51-year-old man with a history of hypertension and dyslipidemia suddenly experienced right facial numbness and dysphasia while front crawl swimming, which he usually did 3 times weekly. Diffusion-weighted magnetic resonance imaging showed high intensity areas in the left frontal and parietal lobes. He was diagnosed with acute cerebral infarction and was administered with tissue plasminogen activator. Angiography of the left CCA revealed mild stenosis with an intravascular filling defect, and carotid duplex ultrasonography of the CCA on the second day after symptom onset showed plaque and intraluminal thrombus at the stenotic site. Plain and contrast-enhanced computed tomography showed that thyroid cartilage contacted the left CCA at the stenotic site, and the left CCA moved backward and forward with the thyroid cartilage during neck rotation. We determined that mechanical stimulation by the thyroid cartilage had induced the plaque during the frequent neck rotation that is a feature of front crawl swimming. Conclusions: Evaluation of anatomical interactions between the carotid artery and bony structures including the thyroid cartilage is important to ensure that appropriate treatment is selected to prevent further ischemia.
机译：背景：颈动脉周围的骨骼结构，如茎突和肿瘤骨，可引起颈动脉的解剖，压缩，牙菌斑形成和牙菌斑破裂。据我们所知，这种情况是第一次发现甲状腺软骨是对应于相邻颈动脉（CCA）动脉粥样硬化的病变的原因。案例描述：一名51岁的男子患有高血压和血脂血症的历史突然突然经历了正确的面部麻木和困扰，而前爬行游泳，他通常每周做3次。扩散加权磁共振成像显示出左前部和顶叶的高强度​​区域。他被诊断出患有急性脑梗塞，并用组织纤溶酶原激活剂施用。左CCA的血管造影显示出轻微的狭窄，患有血管内填充缺损和CCA的颈动脉双链超声检查，在症状发作后第二天在狭窄部位显示斑块和腔内血栓。普通和对比增强的计算机断层摄影显示甲状腺软骨在狭窄部位接触左下CCA，左侧CCA向后移动并在颈部旋转期间与甲状腺软骨向前移动。我们确定甲状腺软骨的机械刺激在频繁的颈部旋转期间诱导斑块，这是前爬行游泳的一个特征。结论：在包括甲状腺软骨中的颈动脉和骨骼结构之间解剖相互作用的评价对于确保选择适当的处理以防止进一步缺血是重要的。

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