Craniocervical artery dissection is a potentially disabling condition caused by an intimal tear allowing blood to enter and dissect the media in the cranial direction which can occur spontaneously or as a result of trauma. When the dissection extends toward the adventitia, it can form a protrusion from the weakened vessel wall called a pseudoaneurysm, which may become a nidus for distal thromboembolism or cause mass effect on adjacent structures. Accurate and prompt diagnosis is critical as timely treatment can significantly reduce the risk of complications such as stroke. Here, we present a case of cervical ICA dissection and pseudoaneurysm formation causing mass effect with resultant compressive ipsilateral hypoglossal nerve palsy.
ObjectiveThe usage of arterial spin labelling (ASL) perfusion has exponentially increased due to improved and faster acquisition time and ease of postprocessing. We aimed to report potential additional findings obtained by adding ASL to routine unenhanced brain MRI for patients being scanned in a hospital setting for various neurological indications.DesignRetrospective.SettingLarge tertiary hospital.Participants676 patients.Primary outcomeAdditional findings from ASL sequence compared with conventional MRI.ResultsOur patient cohorts consisted of 676 patients with 257 with acute infarcts and 419 without an infarct. Additional findings from ASL were observed in 13.9% (94/676) of patients. In the non-infarct group, additional findings from ASL were observed in 7.4% (31/419) of patients, whereas in patients with an acute infarct, supplemental information was obtained in 24.5% (63/257) of patients.ConclusionThe addition of an ASL sequence to routine brain MRI in a hospital setting provides additional findings compared with conventional brain MRI in about 7.4% of patients with additional supplementary information in 24.5% of patients with acute infarct.
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