Cervicocranial Artery Dissection

Bakke, Søren Jacob; Smith, Hans‐Jørgen; Kerty, Emı́lia; Dahl, Arve

doi:10.1177/02841851960373p220

Cited by 14 publications

(1 citation statement)

References 30 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In order to prevent ischemic complications, eICAD patients have been treated with anticoagulation in many centers [10, 11, 12, 13]. Because of possibly harmful effects in a disorder associated with primary (intramural) hemorrhage others prefer antiplatelets [14, 15, 16, 17]. So far, there have been no controlled trials comparing these widely used therapeutic alternatives.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Follow-Up after Extracranial Internal Carotid Artery Dissection

Engelter¹,

Lyrer²,

Kirsch

et al. 2000

Eur Neurol

View full text Add to dashboard Cite

Objective: To evaluate long-term outcome after extracranial internal carotid artery dissection (eICAD) in consideration of the applied antithrombotic therapy. Material and Methods: Among 33 consecutive eICAD patients initially treated either with anticoagulation (n = 25) or with antiplatelets (n = 8), a standardized interview was performed after 28 ± 22.1 months to analyze risks and benefits of both agents. Ischemic and hemorrhagic complications, occurrence of seizure and rates of arterial recanalization were compared and long-term clinical outcome was assessed using the modified Rankin Scale (mRS) and Barthel Index (BI). Results: Among anticoagulated patients, 1 died due to brain herniation. In 3 patients stroke (n = 2) or TIA (n = 1) recurred. In the antiplatelet group, none died and no subsequent ischemic events happened. Hemorrhagic complications were noted in neither treatment group. Functional outcome among anticoagulated patients was BI 92 ± 21.6 and mRS 1.48 ± 1.50, which did not differ from patients initially treated with antiplatelets (BI 89 ± 18.9, mRS 1.50 ± 1.41, p > 0.05). Four anticoagulated patients developed seizures, compared to 2 patients with antiplatelets (p > 0.05). Arterial recanalization occurred in 16 of 22 antico- agulated patients with ultrasound follow-up, compared to 6 of 6 patients with antiplatelets (p > 0.05). Conclusion: In the absence of iatrogenic side effects, both anticoagulation and antiplatelets seem to be safe for eICAD. The rates for death and stroke were low and outcome ratings did not differ between both agents. These findings may indicate that a controlled randomized trial comparing anticoagulation and antiplatelets is ethically justified.

show abstract

Section: Introductionmentioning

confidence: 99%

Long-Term Follow-Up after Extracranial Internal Carotid Artery Dissection

Engelter¹,

Lyrer²,

Kirsch

et al. 2000

Eur Neurol

View full text Add to dashboard Cite

show abstract

Antithrombotic drugs for carotid artery dissection

Lyrer

Engelter

2010

Cochrane Database of Systematic Reviews

137

136

View full text Add to dashboard Cite

xtracranial internal carotid artery dissection can lead to occlusion of the artery and hence cause an ischemic stroke. It is the underlying stroke mechanism in approximately 2.5% of all strokes. It is the second leading cause of stroke in patients younger than 45 years of age. Anticoagulants or antiplatelets may prevent arterial thrombosis in extracranial internal carotid artery dissection, but these benefits may be offset by increased bleeding. ObjectivesTo determine whether antithrombotic drugs (antiplatelet drugs, anticoagulation) are effective and safe in treatment of patients with extracranial internal carotid artery dissection (eICAD), and which is the better treatment. Search StrategyWe searched the Cochrane Stroke Group Trials Register (last searched October 3, 2002). In addition we performed comprehensive searches of the Cochrane Central Register of Controlled Trials (

show abstract

Extracranial internal carotid and vertebral artery dissections: angiographic spectrum, course and prognosis

et al. 2003

View full text Add to dashboard Cite

We reviewed the clinical and radiological findings of 93 consecutive patients with 111 extracranial internal carotid (ICAD) and vertebral artery (VAD) dissections and one concomitant intracranial VAD; 83% of the patients had unilateral and 17% multiple vessel dissections. The diagnosis was made by intra-arterial digital subtraction angiography in 92 patients and MR angiography in one. Follow-up angiography was performed in 77 cases (83%): of 49 initially stenotic arteries, 40 became completely or almost completely normal, while three showed slight improvement. Of 30 initially occluded arteries, nine had completely or partly recanalised. Of 12 pseudoaneurysms eight were unchanged at follow-up. The proximal vertebral artery was involved as often as the C1-C2 level. Recurrences were rare: a new dissection in another vessel was found in three patients. Kinking or coiling was found in 23% of the dissected internal carotid arteries.

show abstract

Cervicocranial Artery Dissection

Abstract: Our findings suggest that Doppler ultrasound may be used in follow-up of pathologic Doppler findings in known dissections, and that MRA may replace angiography in the confirmative diagnosis of cervicocranial dissection.

Cited by 14 publications

References 30 publications

Long-Term Follow-Up after Extracranial Internal Carotid Artery Dissection

Long-Term Follow-Up after Extracranial Internal Carotid Artery Dissection

Antithrombotic drugs for carotid artery dissection

Extracranial internal carotid and vertebral artery dissections: angiographic spectrum, course and prognosis

Contact Info

Product

Resources

About