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首页> 外文期刊>British journal of neurosurgery >Surgical treatment of foreign body embolus in the Middle cerebral artery secondary to neck injury
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Surgical treatment of foreign body embolus in the Middle cerebral artery secondary to neck injury

机译：中脑动脉中颈部损伤中的外身栓塞的外科治疗

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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.
机译：背景：我们向中脑动脉报告了外来体内栓塞的情况，并审查了先前报告的类似案例。方法：在颈部损伤渗透颈部损伤后72天看到一名30岁的人，左肢体的麻木历史和左手微小运动的损害。放射检查显示右中脑动脉（MCA）的M2部分中的异物。病人接受了动脉和原位缝合。结果：在手术过程中，我们在右下MCA的M2上躯干的分叉处发现了金属异物，狭窄的远端血管和薄血管壁。异物被肉芽组织包围。将异物和造粒组织缓慢除去，然后原位缝合。吲哚菁绿色血管造影证实了动脉通畅。手术后三天，患者在左臂发育麻木和虚弱，具有4级肌肉力量。计算断层摄影显示出右颞叶的部分梗死。然后，使用抗痉挛药。肌肉力量在手术后14天恢复。结论：在亚急期阶段，如果计算机断层扫描灌注，可以进行手术以除去动脉内异物以及周围的肉芽组织，如果计算断层扫描灌注表明血流储备储备的减少。

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