颈性眩晕的椎动脉起始段（V1段）血管形态病理学改变

摘要

[目的]探索颈性眩晕的椎动脉起始段（V1段）血管形态病理学改变。[方法]回顾1999年至2011年以头晕为主症，符合寰枕痛、恶心（呕吐）、耳鸣（耳塞）、视物模糊（视物旋转）4项症状中2项以上，经颅多普勒检测有椎-基底动脉血流速增快或减慢患者1680例，分析这些患者的椎-基底动脉CT血管造影三维重建技术（3D-CTA）的血管形态影像资料，观察椎动脉V1段血管形态病理学改变情况。[结果]颈性眩晕患者椎动脉V1段血管形态病理学有椎动脉纤细、椎动脉痉挛、椎动脉穿孔位置异常、椎动脉走行迂曲、椎动脉起始源异常、椎动脉瘤（或伴钙化）6种改变。[结论]颈性眩晕的椎动脉V1段存在6种血管形态病理学改变，根据这些病理改变，有助于在临床上判断预后，选择不同手法进行针对性地治疗，并指导患者在生活中的注意事项。%Objective] To explore the pathomorphological change of the initial segment of vertebral artery(V1 part) related with cervical vertigo. [Method] Review 1680 cases who had vertigo as primary symptom, associated with either 2 or more symptoms as fol ows: neck pain, nausea(or vomit), tinnitus(or ear stuffiness), blurred vision(or rotation). Al the cases had TCD examination which showed over fast or too slow blood flow speed, and 3D-CTA examination(Three-Dimensional Computed Tomography Angiography). The pathomorphological change of the initial segment of vertebral artery was observed through 3D-CTA technology. [Results] There were 6 kinds of pathomorphological changes in the initial segment of vertebral artery. They were tenuous vertebral artery, spasm vertebral artery, abnormal position of vertebral artery entering cervical transverse foramen, circuitous vertebral artery, abnormal initiating terminal, vertebral artery aneurysm(or associated with calcification).[Conclusion]There are 6 kinds of pathomorphological changes in the initial segment of vertebral artery related with cervical vertigo. Under these pathological changes, it is helpful to judge the prognosis clinical y, select different manipulations for pointing treatment, and guide the patients' matters needing attention in life.