Dissecting aneurysms of intracranial arteries

Scott, George E.; Neubuerger, Karl T.; Denst, John

doi:10.1212/wnl.10.1.22

Cited by 64 publications

(27 citation statements)

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“…There is narrowing of the vascular lumen secondary to the subintimal hematoma (string sign), with or without segmental dilatation proximal or distal to the stenosis (string and pearl sign) (1,2,3,15). The lumen is often irregular or asymmetrical.…”

Section: Case Reportsmentioning

confidence: 99%

Isolated Posterior Cerebral Artery Dissection: Report of Three Cases

Sherman¹

2005

PsycEXTRA Dataset

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Section: Case Reportsmentioning

confidence: 99%

Isolated Posterior Cerebral Artery Dissection: Report of Three Cases

Sherman¹

2005

PsycEXTRA Dataset

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“…15,16) Histological evaluation of dissecting aneurysms of the cerebral arteries has suggested that defects in the IEL or media, or degeneration of the media induce intimal changes, and rupture of the intima results in dissection of the arterial wall. 1,4,6,7,15,[17][18][19][20][21] Other dissections were attributed to rupture of the vasa vasorum or a newly formed vessel in the vascular wall associated with degeneration of the media. 5,28) The intima and IEL at the opening of a dissection are washed away by blood, so preventing histological investigation.…”

Section: Introductionmentioning

confidence: 99%

Histological Study of the Normal Vertebral Artery-Etiology of Dissecting Aneurysms-

Sato

Sasaki

Suzuki

et al. 2004

Neurol. Med. Chir.(Tokyo)

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Histological evaluation of dissecting aneurysms of the cerebral arteries has suggested that defects in the internal elastic lamina (IEL) induce dissection of the arterial wall. Dissecting aneurysms occur most frequently in the vertebral artery (VA). The present study examined sections of the normal VA to elucidate the mechanisms of arterial dissection. Bilateral VAs (20 vessels) were obtained from 10 patients who died of causes other than intracranial lesions. The VAs were detached from the VA union to the site 10 mm proximal from the point penetrating the dura mater. The VAs were cut at 5-mm intervals, and each segment was observed using modified Masson's trichrome staining for elastic fibers. The thickness of the media and adventitia significantly thinned after the origin of the posterior inferior cerebellar artery (PICA). IEL defects were observed at 35 sites in 11 vessels from six subjects. There was a high incidence of IEL defects in the extradural portion and near the origin of the PICA, areas frequently involved in arterial dissection. There was a high incidence of intimal thinning at areas of IEL defects (19 of 35), and thinning was particularly marked distal to the origin of the PICA. In the absence of intimal thickening, the vascular strength at the site of IEL defects may be reduced, which would promote the occurrence and progression of arterial dissection.

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“…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.…”

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confidence: 99%