Benign arterial dissections of the posterior circulation

Abstract

Four young adults with spontaneous dissection of the vertebrobasilar system are reported. Clinically, two patients presented with subarachnoid hemorrhage and two with brain-stem ischemia. In two cases of ruptured arterial dissection of the posterior cerebral artery, angiography demonstrated fusiform and "sausage-like" dilatation of the involved vessel. In two cases of occlusive dissection of the basilar artery, angiography revealed the typical "string sign." All four patients were treated conservatively: three survive in good clinical condition and one remains disabled. Follow-up angiograms showed spontaneous healing of the lesion with return to an almost normal arterial configuration in two cases; residual narrowing corresponding to the dissection was the most notable finding in the other two. It is recommended that, in a subset of neurologically stable patients, angiographic monitoring is undertaken to assess the tendency for spontaneous repair before surgical intervention is planned.

Clinical and Neuroradiological Features of Intracranial Vertebrobasilar Artery Dissection

“…Conventional arteriography and/or digital subtraction angiography with selective catheterization of vertebral arteries was performed in all 31 patients. In angiographic findings, the double lumen sign (the presence of a false lumen or an intimal flap) 1,2,16,17 and the pearl and string sign 1,4,5,18 were used as reliable angiographic findings of vertebrobasilar artery dissection. Of the other reported abnormal findings suggesting vertebrobasilar artery dissection, a string sign, 1 tapered narrowing, 1,19 total occlusion with proximal distension, 1 and retention of contrast medium 1,3 were not considered pathognomonic signs.…”

Isolated Posterior Cerebral Artery Dissection: Report of Three Cases

“…Intracranial arterial dissections most often involve the vertebrobasilar system and, less commonly, the middle and anterior cerebral arteries (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). Isolated dissection of the PCA is rare (12)(13)(14)(15)(16)(17)(18), but accurate diagnosis is important for appropriate clinical management.…”

Dissecção da artéria basilar: relato de caso

“…As dissecções arteriais cérvico-cefálicas são analisadas em vários estudos [1][2][3][4][5][6][7][8] . Atingem comumente as artérias carótidas e são menos frequentes no território vertebrobasilar.…”

“…[1][2][3][4][5][6][7][8] As dissecções arteriais representam parte das etiologias definidas. Essas dissecções atingem as artérias carótidas e vertebrobasilares, sendo pouco frequentes neste último grupo, o envolvimento isolado da artéria basilar uma exceção.…”