Diagnosis and follow-up of posterior inferior cerebellar artery dissection complicated with ischemic stroke assisted by T1-VISTA: a report of two cases

Ishitsuka, Koji; Sakaki, Yusuke; Sakaï, Shota; Uwatoko, Takeshi; Aibe, Hitoshi; Ago, Tetsuro; Kitazono, Takanari; Sugimori, Hiroshi

doi:10.1186/s12883-016-0637-9

Cited by 11 publications

(7 citation statements)

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“…Recent advances in MRI may improve the diagnostic accuracy to detect the presence and extent of PICA dissection. [13] This study may also be valuable given that follow-up imaging studies were performed in as many as 86% of patients with AD-related CI [Table 3]. Progression of AD in the acute phase (i.e., the progression within 14 days of onset) was observed in 2 of the 14 patients (14%), which was compatible with current literature.…”

Section: Discussionsupporting

confidence: 83%

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Clinical characteristics of cerebellar infarction due to arterial dissection

et al. 2018

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Objectives and Background:Arterial dissection (AD) of the vertebral artery (VA) or its branches may cause ischemic stroke of the posterior circulation. However, clinical and radiological characteristics of patients with AD-related cerebellar infarction (CI) have rarely been reported.Methods:Forty-nine patients with CI admitted to our department from April 2008 to March 2015 were identified from our database. After dichotomization into the AD and non-AD group, their demographics and presenting symptoms were compared. Subsequently, a multivariate regression analysis was performed to identify variables that correlated with AD.Results:During the 7-year period, 14 and 35 patients were identified in the AD and non-AD group, respectively. The AD group was significantly younger than the non-AD group (55.0 ± 16.3 vs. 69.7 ± 10.7 years, P = 0.001) and was also more likely to experience acute pain at onset (86% vs. 17%, P < 0.001). Using a multivariate regression analysis, these two variables and the male sex were found to correlate with AD. AD was located in extracranial VA (n = 3); intracranial VA (n = 8); posterior inferior cerebellar artery (PICA) (n = 3); and superior cerebellar artery (n = 1). Identification of AD was delayed in one patient with an extracranial VA and one patient with a PICA dissection.Conclusions:AD was responsible for approximately 30% of CI in our cohort. Pain at onset may be a useful symptom to identify patients with AD-related CI. While intracranial VA was the most common location of AD, physicians should be aware of the possibility of extracranial VA or PICA dissection in patients with seemingly unremarkable radiological findings.

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Section: Discussionsupporting

confidence: 83%

“…Recent advances in MRI may improve the diagnostic accuracy to detect the presence and extent of PICA dissection. [ 13 ]…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of cerebellar infarction due to arterial dissection

et al. 2018

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“…Although isolated PICA dissection is rare, it had been underdiagnosed which leads to the occurrence of ischemic stroke of the posterior circulation [5]. Recent studies have shown that isolated PICA dissection can be diagnosed using HR vw-MRI [1–3]. In most case studies, intramural hematoma, dilated lumen, or pearl-and-string appearance were seen on HR vw-MRI.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is still difficult to accurately diagnose PICA dissection because the size of the PICA is very small. Recent studies have diagnosed isolated PICA dissection in patients by using high-resolution vessel wall MRI (HR vw-MRI), in which a T1 hyperintense intramural hematoma was the main finding [1–3]. Although an intramural hematoma is a pathognomonic sign of PICA dissection, it may be necessary to distinguish it from intraplaque hemorrhage.…”

Section: Introductionmentioning

confidence: 99%

Intimal flap detected by three-dimensional curved multiplanar reconstruction image in isolated posterior inferior cerebellar artery dissection: a report of two cases

et al. 2019

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Background Spontaneous isolated posterior inferior cerebellar artery (PICA) dissection has been reported more frequently since high-resolution vessel wall magnetic resonance imaging (HR vw-MRI) was introduced to the field. The intimal flap or double lumen, which is commonly reported to be a direct sign of the dissection, is not easily detectable on HR vw-MRI because the size of the PICA is very small and tortuous. Case presentation Two patients with posterior circulation ischemic stroke due to spontaneous isolated PICA dissection underwent HR vw-MRI. The curved multiplanar reconstruction image reconstructed using three-dimensional (3D) HR vw-MRI (3D curved MPR imaging) is helpful to observe tortuous blood vessels such as the PICA because it can visualize the entire vessel course in a single plane. In this report, routine HR vw-MRI revealed only an intramural hematoma in both patients. However, 3D curved MPR imaging discovered the intimal flap which was not observed on the routine HR vw-MRI. Therefore, these two patients were diagnosed with spontaneous isolated PICA dissection due to the intimal flap that was observed on the 3D curved MPR image. Conclusion HR vw-MRI is useful for the early diagnosis of isolated PICA dissection. Furthermore, we believe that 3D curved MPR imaging could improve the possibility of diagnosing the dissection early because it can easily confirm direct signs such as an intimal flap or double lumen.

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“…Survey of studies focused on 1 vasculopathy revealed intracranial atherosclerotic disease (ICAD) to be the most commonly studied vasculopathy (49%, n = 62, references in the On-line Appendix), followed by arterial dissection (13%, n = 16), 10,12 -26 aneurysm (8%, n = 10), [27][28][29][30][31][32][33][34][35][36] vasculitis (5%, n = 6), [37][38][39][40][41][42] Moyamoya disease (3%, n = 4), [43][44][45][46] postendovascular changes (2%, n = 3), [47][48][49] and reversible cerebral vasoconstriction syndrome (1%, n = 1) 50 ( Fig 3C). Among the 16 publications investigating arterial dissections, 11 used VWI 12,[14][15][16][17][18][22][23][24][25][26] and the other 5 publications 10,13,[19][20][21] assessed intramural hematoma signal characteristics on conventional MR imaging. Note that 21% of the studies examined $2 types of vasculopathies; a breakdown of the types of vasculopathies studied among these publications is further illustrated in the piein-pie chart.…”

Section: Publication Trendsmentioning

confidence: 99%

Qualitative Assessment and Reporting Quality of Intracranial Vessel Wall MR Imaging Studies: A Systematic Review

Song¹,

Guiry²,

Shou

et al. 2019

AJNR Am J Neuroradiol

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BACKGROUND: Over the last quarter-century, the number of publications using vessel wall MR imaging has increased. Although many narrative reviews offer insight into technique and diagnostic applications, a systematic review of publication trends and reporting quality has not been conducted to identify unmet needs and future directions. PURPOSE: We aimed to identify which intracranial vasculopathies need more data and to highlight areas of strengths and weaknesses in reporting. DATA SOURCES: PubMed, EMBASE, and MEDLINE databases were searched up to September 2018 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA ANALYSIS: Two independent reviewers screened and extracted data from 128 articles. The Strengthening the Reporting of Observational Studies in Epidemiology guidelines were used to assess the reporting quality of analytic observational studies.

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Diagnosis and follow-up of posterior inferior cerebellar artery dissection complicated with ischemic stroke assisted by T1-VISTA: a report of two cases

Cited by 11 publications

References 9 publications

Clinical characteristics of cerebellar infarction due to arterial dissection

Clinical characteristics of cerebellar infarction due to arterial dissection

Intimal flap detected by three-dimensional curved multiplanar reconstruction image in isolated posterior inferior cerebellar artery dissection: a report of two cases

Qualitative Assessment and Reporting Quality of Intracranial Vessel Wall MR Imaging Studies: A Systematic Review

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