Craniocervical Arterial Dissection: Spectrum of Imaging Findings and Differential Diagnosis

Abstract

Craniocervical artery dissection is a potentially disabling yet probably underrecognized condition that often occurs in young and middle-aged adults. Accurate and prompt diagnosis of this condition is crucial because timely and appropriate therapy can significantly reduce the risk of stroke and long-term sequelae. Because of the great diversity in the clinical features of craniocervical artery dissection, imaging plays a primary role in its diagnosis. The increased diagnosis of this disorder in the past two decades can be attributed to an increased awareness of the clinical manifestations of internal carotid artery and vertebral artery dissection and to use of noninvasive diagnostic imaging techniques. To achieve an accurate diagnosis of craniocervical artery dissection, it is important to be familiar with its pathologic features (intimal tear, intramural hematoma, and dissecting aneurysm); the spectrum of imaging findings at color duplex ultrasonography, computed tomographic angiography, magnetic resonance (MR) imaging with MR angiography, and conventional angiography; and potential pitfalls in image interpretation.

Radiological Diagnosis and Differential Diagnosis of Headache

“…The result can be consecutive narrowing of the true lumen or formation of a pseudoaneurysm if the tear is subadventitial [26,27]. In the [12]).…”

“…Unauthorized distribution is strictly prohibited. majority of cases, dissection is spontaneous; additional risk factors include trauma or manipulation of the cervical spine and pre-existing connective tissue disease [26].…”

The effect of end-range cervical rotation on vertebral and internal carotid arterial blood flow and cerebral inflow: A sub analysis of an MRI study

“…The majority of these studies utilise ultrasound imaging which is highly operator dependent (Zwiebel 2000, Rivett, Sharples et al 2003. Few studies have utilised angiography, which is the reference standard for investigation of the craniocervical arterial system (Rodallec, Marteau et al 2008).…”

Surgical positicion, cause of extracranial internal carotid artery disection, presenting as pourfour du petit sundrome. case report and literature review

“…Most strokes occur in the first week of local symptoms onset and are located in the territory of the middle cerebral artery. Diagnosis can be made by angiography, computed tomography angiography (CTA), magnetic resonance angiography (MRA) and ultrasound (20). Differential diagnosis is required with respect to cluster headache, migraine, retinal artery occlusion, herpes zoster and musculoskeletal neck pain (16,19,24).…”