相撲の稽古中に発症した外傷性椎骨動脈閉塞:2例報告  [in Japanese] Traumatic vertebral artery occlusion caused by during sumo practice; two case reports  [in Japanese]

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Abstract

外傷性椎骨動脈閉塞は交通事故によるものが多いが,近年スポーツに伴う報告が散見される。相撲の稽古中に発症した 2 例を報告する。症例 1 は17歳の男性で相手の胸に前額部を強打し頭痛・嘔吐を主訴に来院した。magnetic resonance imaging(MRI)で右posterior inferior cerebellar artery(PICA)領域の多発性脳梗塞,magnetic resonance angiography(MRA)・脳血管撮影検査で右椎骨動脈閉塞を認めた。症例 2 は16歳の男性で張り手を顔面に受け,後頸部痛と回転性のめまい,左上下肢のしびれが出現したため受診した。MRIで右延髄外側の脳梗塞,MRA・脳血管撮影検査で右椎骨動脈閉塞を認めた。 2 症例とも外傷性椎骨動脈閉塞に伴う脳梗塞の診断でエダラボンの点滴加療を行い,神経学的脱落症状なく自宅退院した。頭頸部の回旋,過伸展に伴う外傷性椎骨動脈閉塞はスポーツに伴う若年者の閉塞性血管障害の原因の一つであり,スポーツ医学の見地から救急医に注意を喚起する意味で報告する。

Although traumatic vertebral artery occlusion is primarily caused by traffic accidents, it has been reported to occur in sports in recent years. Herein, we present two cases that occurred during sumo practice. The first case was a 17-year-old boy who visited our hospital with chief complaints of headache and vomiting after knocking his forehead against his opponent's chest. Magnetic resonance imaging (MRI) showed multiple cerebral infarctions in the right posterior inferior cerebellar artery (PICA) territory, while magnetic resonance angiography (MRA) and cerebral angiography revealed right vertebral artery occlusion. The second case was a 16-year-old boy who presented with posterior cervical pain, vertigo, and numbness in the left arm and leg after being slapped in the face. MRI showed a cerebral infarction in the right lateral medulla oblongata, while MRA and cerebral angiography revealed right vertebral artery occlusion. Both patients were diagnosed with cerebral infarction associated with traumatic vertebral artery occlusion and discharged with no neurological deficit following intravenous edaravone treatment. As traumatic vertebral artery occlusions caused by rotation or hyperextension of the head and neck in sports are a cause of occlusive vascular disease among youths, we report the present study with the purpose of promoting awareness among emergency physician from the perspective of sports medicine.

Journal

  • Nihon Kyukyu Igakukai Zasshi

    Nihon Kyukyu Igakukai Zasshi 20(5), 282-287, 2009

    Japanese Association for Acute Medicine

Codes

  • NII Article ID (NAID)
    130004542234
  • Text Lang
    JPN
  • ISSN
    0915-924X
  • Data Source
    J-STAGE 
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