颈内动脉夹层, 视网膜中央动脉阻塞, 头痛, internal carotid artery dissection, central retinal artery occlusion, headache, Neurology. Diseases of the nervous system, RC346-429

内动脉夹层是视网膜中央动脉阻塞十分少见的原因。本文介绍了1例突发右眼视力下降伴头痛1周的中年男性患者的诊疗过程，该患者缺乏心脑血管病高危因素，经眼底检查诊断为视网膜中央动脉阻塞，经头颅CTA、颈动脉HR-MRI诊断为右侧颈内动脉夹层合并左侧椎动脉夹层。考虑为右侧颈内动脉夹层致视网膜中央动脉阻塞，予以抗栓治疗后患者后续无心脑血管事件发生，随访影像发现夹层血管完全再通。本文旨在提示临床医师，对缺乏心脑血管病危险因素的患者，突发头痛伴单眼视力下降，应警惕颈内动脉夹层的发生。 Abstract: Central retinal artery occlusion caused by internal carotid artery dissection is rare. This paper described the diagnosis and treatment process of a middle-aged male patient who experienced sudden reduction in vision in the right eye accompanied by headache for one week. The patient lacked high-risk factors for cardiovascular and cerebrovascular diseases. The fundus examination confirmed central retinal artery occlusion. Diagnosed with right internal carotid artery dissection combined with left vertebral artery dissection through cranial CTA and cervical artery HR-MRI. The patient was diagnosed with central retinal artery occlusion caused by right internal carotid artery dissection. After antithrombotic therapy, the patient did not experience subsequent cardiovascular or cerebrovascular events, and follow-up images revealed complete recanalization of the dissecting arteries. This paper aims to alert clinicians that for patients without risk factors for cardiovascular and cerebrovascular diseases, sudden headache accompanied by unilateral vision loss should raise the suspicion of internal carotid artery dissection.