既往史：既往健康状况一般，无特殊。神经系统查体：神志清楚， GCS 1

Past history: Past health status is average and nothing special. <br>Nervous system examination: Consciousness, GCS 15 points, no positive signs, pathological signs (-), cervical obstruction (-) Imaging examination: CTA: left internal carotid artery dissecting aneurysm with arterial stenosis. <br>DSA: Aneurysm of the extracranial segment of the left internal carotid artery, about 5*8mm in size, irregular in shape, and local carotid artery stenosis. <br>Preoperative diagnosis: dissecting aneurysm of the extracranial segment of the left internal carotid artery. <br>Three days before the operation, 100 mg of aspirin and 75 mg of clopidogrel were taken orally, cerebral angiography under general anesthesia, stent-assisted aneurysm closure of the left internal carotid artery dissecting aneurysm, the treatment went smoothly, and antispasmodic, symptomatic and supportive treatment was given after the operation. <br>After the operation, low-molecular-weight heparin was injected subcutaneously for 3 days, aspirin was taken until 6 months after the operation, and clopidogrel was taken until 3 months after the operation. <br>Case 2: Basic situation: patient, female, 46 years old. <br>Main complaint: 3 months after the operation of the intracranial aneurysm, an aneurysm in the extracranial segment of the right internal carotid artery was found for 10+ days. <br>Medical history: 3 months before admission, the patient underwent DSA examination in our hospital. He underwent craniotomy for "left posterior communicating artery aneurysm" and had a good recovery after surgery. CTA of the head was reviewed 6+ months later, indicating intracranial arteries. The aneurysm was clipped, and an aneurysm of the extracranial segment of the right internal carotid artery was found. After communicating with his family, interventional embolization was performed. <br>Physical examination: Consciousness, no positive signs, pathological signs (-), neck resistance (-), GCS 15 points. <br>Imaging examination: CTA: Extracranial aneurysm of the right internal carotid artery, postoperative manifestations of intracranial aneurysm clipping. <br>DSA: Aneurysm of the extracranial segment of the right internal carotid artery, about 8*4mm in size and irregular in shape. <br>Preoperative diagnosis: right internal carotid artery extracranial aneurysm, left posterior communicating aneurysm after clipping. <br>Three days before the operation, 100 mg of aspirin and 75 mg of clopidogrel were taken orally. <br>Treatment: stent placement in the extracranial segment of the right internal carotid artery under general anesthesia. <br>Antispasmodic, symptomatic and supportive treatments were given after surgery.<br>Aspirin 100mg qd and clopidogrel 75mg qd were taken until 6M after operation. <br>Case 3: Basic situation: Patient, male, 66 years old. <br>Main complaint: Repeated haze of left eye for 1 week. <br>Medical history: 1 week before admission, the patient developed black haze in the left eye, which was paroxysmal, with a total of 3-4 attacks, 3-4 seconds each. Part of the visual field was missing at the time of the onset, followed by hazy haze. "Ischemia Attack" was admitted to the hospital. <br>Past history: Past health status is average, with a history of "colon polyp enteroscopy". <br>Imaging examination: head and neck CTA: left internal carotid artery dissecting aneurysm. <br>Cranial DSA: Dissecting aneurysm of the extracranial segment of the left internal carotid artery. <br>Admission diagnosis: <br>1. Dissecting aneurysm of the left internal carotid artery 2. Transient ischemic attack of the carotid artery system. <br>Cerebral angiography under general anesthesia, left internal carotid artery dissecting aneurysm stent assisted aneurysm closure, postoperative spasmolysis, symptomatic and supportive treatment. <br>Main complaint: dizziness for 9 hours, aggravated with weakness of the right limb for 6+ hours. <br>Medical history: 9+ hours before admission, dizziness, headache, nausea, vomiting, vomiting stomach contents, floating sensation, local medical treatment, no relief; 6+ hours ago, the patient felt dizziness worsened, accompanied by nausea and vomiting , The right limb is weak and unable to speak. <br>Anamnesis: Appendectomy was performed 10+ years ago. <br>Nervous system examination: clear, shallow right nasolabial fold, right tongue extension, good teeth, neck obstruction (-), right upper limb muscle strength level 1, right lower limb muscle strength level 2, slightly right muscle tone Low, right tendon reflex (+), left muscle strength, muscle tone, and tendon reflex are normal, right Pap sign (+).

既往史：既往健康状况一般，无特殊。<br>神经系统查体：神志清楚， GCS 15分，未见阳性体征，病理征（-），颈阻（-）影像学检查：CTA:左颈内动脉夹层动脉瘤伴动脉狭窄。<br>DSA:左侧颈内动脉颅外段动脉瘤，大小约5*8mm，形态不规则，局部颈动脉狭窄改变。<br>术前诊断：左颈内动脉颅外段夹层动脉瘤。<br>术前3天口服阿司匹林100mg，氯吡格雷75mg，全麻下行脑血管造影，左侧颈内动脉夹层动脉瘤支架辅助动脉瘤闭合术，治疗顺利，术后给予解痉、对症及支持治疗。<br>术后行低分子肝素皮下注射3天，服用阿司匹林至术后6月，服用氯吡格雷至术后3月。<br>病例2：基本情况:患者，女性， 46岁。<br>主 诉：颅内动脉瘤术后3月，发现右侧颈内动脉颅外段动脉瘤10+天。<br>病史：入院前3月，患者在我院行ＤＳＡ检查，因“左侧后交通动脉瘤”行开颅动脉瘤夹闭术，术后恢复好，6+月后复查头颅CTA，提示颅内动脉瘤已夹闭，发现右侧颈内动脉颅外段动脉瘤，经与家属沟通后，行介入栓塞治疗。<br>查体：神志清楚，未见阳性体征，病理征（-），颈阻（-），GCS 15分。<br>影像学检查：CTA:右侧颈内动脉颅外段动脉瘤，颅内动脉瘤夹闭术后表现。<br>DSA:右侧颈内动脉颅外段动脉瘤，大小约8*4mm，形态不规则。<br>术前诊断：右侧颈内动脉颅外段动脉瘤，左侧后交通动脉瘤夹闭术后。<br>术前3天口服阿司匹林100mg，氯吡格雷75mg。<br>治疗：全麻下行侧右颈内动脉颅外段动脉瘤载瘤动脉支架置入术。<br>术后给予解痉、对症及支持治疗。<br>术后阿司匹林100mg qd，氯吡格雷75mg qd服用至术后6M。<br>病例3：基本情况：患者，男， 66岁。<br>主 诉：反复左眼阵性黑朦1周。<br>病史：入院前1周患者出现左眼黑朦，呈阵发性，共发作3-4次，每次发作3-4秒，发病时首先出现视野部分缺失，随之出现黑朦，门诊以“短暂性脑缺血发作”收入院。<br>既往史：既往健康状况一般，有“结肠息肉肠镜下手术”史。<br>影像学检查：头颈部CTA:左侧颈内动脉夹层动脉瘤。<br>头颅DSA:左侧颈内动脉颅外段夹层动脉瘤。<br>入院诊断：<br>1.左侧颈内动脉夹层动脉瘤 2.颈动脉系统短暂缺血发作。<br>全麻下行脑血管造影，左侧颈内动脉夹层动脉瘤支架辅助动脉瘤闭合术，术后给予解痉、对症及支持治疗。<br>主 诉：头晕9小时，加重伴右侧肢体无力6+小时。<br>病 史：入院前9+小时无明显诱因出现头晕、头痛，伴恶心，呕吐，呕吐胃内容物，伴行走漂浮感，当地就诊，无缓解；6+小时前，患者感头晕加重，伴恶心，呕吐，右侧肢体无力，不能言语。<br>既往史：10+年前曾行阑尾切除术。<br>神经系统查体：神清，右侧鼻唇沟浅，伸舌偏右、露齿可，颈阻（-），右侧上肢肌力1级，右下肢肌力2级，右侧肌张力稍低，右侧腱反射（+），左侧肌力、肌张力、腱反射正常，右侧巴氏征（+）。

Past history: the past health condition is general, no special.<br>Neurological examination: conscious, GCS 15 points, no positive signs, pathological sign (-), carotid resistance (-) imaging examination: CTA: left internal carotid artery dissection aneurysm with arterial stenosis.<br>DSA: the aneurysms in the extracranial segment of the left internal carotid artery were about 5 * 8mm in size, with irregular shape and local carotid artery stenosis.<br>Preoperative diagnosis: dissecting aneurysm of extracranial segment of left internal carotid artery.<br>Three days before the operation, 100 mg aspirin and 75 mg clopidogrel were taken orally. Cerebral angiography was performed under general anesthesia. The left internal carotid artery dissecting aneurysm stent assisted aneurysm closure was performed successfully. Spasmolysis, symptomatic and supportive treatment were given after the operation.<br>The patients received subcutaneous injection of low molecular weight heparin for 3 days, aspirin for 6 months and clopidogrel for 3 months.<br>Case 2: basic information: patient, female, 46 years old.<br>Chief complaint: 3 months after the operation of intracranial aneurysm, the aneurysm of extracranial segment of right internal carotid artery was found for 10 + days.<br>Medical history: 3 months before admission, the patient underwent DSA examination in our hospital. Because of the "left posterior communicating artery aneurysm", the aneurysm was clipped and recovered well. 6 + months later, the CTA of the head showed that the intracranial aneurysm had been clipped. After communicating with the family members, the patient underwent interventional embolization.<br>Physical examination: clear mind, no positive sign, pathological sign (-), neck obstruction (-), GCS 15 points.<br>Imaging examination: CTA: right internal carotid artery extracranial aneurysm, intracranial aneurysm after clipping.<br>DSA: the aneurysm of the extracranial segment of the right internal carotid artery was 8 * 4mm in size and irregular in shape.<br>Preoperative diagnosis: right internal carotid artery extracranial aneurysm, left posterior communicating artery aneurysm after clipping.<br>Aspirin 100 mg and clopidogrel 75 mg were given orally 3 days before operation.<br>Treatment: under general anesthesia, stent implantation was performed on the parent artery of the extracranial segment of the right internal carotid artery.<br>The patients were given antispasmodic, symptomatic and supportive treatment.<br>Aspirin 100mg QD and clopidogrel 75mg QD were taken until 6m after operation.<br>Case 3: basic information: patient, male, 66 years old.<br>Chief complaint: recurrent paroxysmal amaurosis in left eye for 1 week.<br>History: one week before admission, the patient developed amaurosis in the left eye, which was paroxysmal, with a total of 3-4 times, and each attack lasted for 3-4 seconds. At the onset of the disease, part of the visual field was lost, followed by amaurosis. The outpatient department was admitted to the hospital with "transient ischemic attack".<br>Past history: he had a general health condition and had a history of "colonoscopic surgery for colonic polyps".<br>Imaging examination: head and neck CTA: left internal carotid artery dissecting aneurysm.<br>DSA: dissecting aneurysm of extracranial segment of left internal carotid artery.<br>Admission diagnosis:<br>1. Left internal carotid artery dissecting aneurysm; 2. Transient ischemic attack of carotid system.<br>Cerebral angiography was performed under general anesthesia, left internal carotid artery dissecting aneurysm stent assisted aneurysm closure, and spasmolysis, symptomatic and supportive treatment were given after operation.<br>Chief complaint: dizziness for 9 hours, aggravation with weakness of right limbs for 6 + hours.<br>Medical history: 9 + hours before admission, there was no obvious cause of dizziness and headache, accompanied with nausea, vomiting, vomiting of gastric contents, accompanied by walking and floating feeling, and no remission was found in local doctors; 6 + hours before admission, the patient felt dizziness aggravated, accompanied with nausea and vomiting, and the right limb was weak, unable to speak.<br>Previous history: appendectomy was performed 10 + years ago.<br>Physical examination of nervous system: Shenqing, superficial nasolabial groove on the right side, right tongue extension, fair tooth exposure, neck resistance (-), muscle strength of right upper limb grade 1, muscle strength of right lower limb grade 2, slightly lower right muscle tension, right tendon reflex (+), normal left muscle strength, muscle tension and tendon reflex, right Barthel sign (+).<br>