Evaluation of Extracranial Vertebral Artery Dissection With Duplex Color-Flow Imaging

Bartels, Eva; Flügel, K. A.

doi:10.1161/01.str.27.2.290

Cited by 98 publications

(61 citation statements)

References 27 publications

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“…VAD characteristics. In the larger study on the topic, where 15 patients have been enrolled [15], a dissection was primarily detect with duplex color-flow imaging. In these patients the interval between the initial clinical symptoms and ultrasound examination was 2-3 days (range 0.5-4).…”

Section: Discussionmentioning

confidence: 99%

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What does Doppler Ultrasonography Brings to the Diagnosis of Traumatic Vertebral Artery Dissection

Caruso¹,

Manganotti²

2016

J Clin Case Rep

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Here we describe the case of a young woman with a late diagnosis of vertebral artery dissection and midbrain ischemic lesion after minor post traumatic injury. Doppler ultrasonography was used as the first diagnostic examination to evaluate the dissection. We present this unusual but not rare case related to the frequent events of cervical distraction after car accident in order to better understand the clinical approach the sensitivity Doppler ultrasonography in post-traumatic cervical distorsion.

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Section: Discussionmentioning

confidence: 99%

“…Color-Doppler sonography, which is a non-invasive and costeffective method, is a suitable screening test for vertebral artery stenosis and dissection [15][16][17]. However, very few studies have been performed to determine Doppler criteria for identifying proximal vertebral artery stenosis [18,19].…”

Section: Discussionmentioning

confidence: 99%

What does Doppler Ultrasonography Brings to the Diagnosis of Traumatic Vertebral Artery Dissection

Caruso¹,

Manganotti²

2016

J Clin Case Rep

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“…10 The use of ultrasonographic techniques in the initial assessment of patients with suspected dissection has invariably required confirmatory testing with additional angiography, either invasively or noninvasively. The technique is dependent on the accessibility of the region to screening and although helpful for proximal dissections, the detection of more distal disease is limited 11,12 Controversy continues as to the optimal management of patients with asymptomatic vertebral artery injury. Guidelines published in 2002 indicated that there was insufficient evidence to support anticoagulation in asymptomatic patients, specifically relating to a 14% risk of complications from anticoagulant use.…”

Section: Discussionmentioning

confidence: 99%

Blunt cervical spine trauma as a cause of spinal cord injury and delayed cortical blindness

et al. 2006

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“…In summary, 12.5% of the screws were considered critical. No alterations to perfusion of the vertebral artery as evaluated by duplex color-flow imaging, which has been proven as a reliable diagnostic tool for the assessment of vertebral artery lesions [3,4], have been detected. None of the malpositioned screw led to clinical symptoms and had to be revised (Group 3).…”

Section: Accuracy Of Pedicle Screw Positionmentioning

confidence: 99%

Percutaneous instrumentation of the cervical and cervico-thoracic spine using pedicle screws: preliminary clinical results and analysis of accuracy

et al. 2011

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The pedicle screw instrumentation represents the most rigid construct of the cervical and cervicothoracic spine and in spite of the risks to neurovascular structures clinical relevant complications do not occur frequently. The steep angles of the cervical pedicles result in a wide surgical exposure with extensive muscular trauma. The objective of this study was the evaluation of the accuracy of cervical pedicle screw insertion through a minimally invasive technique to reduce access-related muscular trauma. Therefore, percutaneous transpedicular instrumentation of the cervical and cervicothoracic spine was performed in 15 patients using fluoroscopy. All instrumentations from C2 to Th4 were inserted bilaterally through 2 to 3-cm skin and fascia incisions even in multilevel procedures and the rods were placed by blunt insertion through the incision. Thin-cut CT scan was used postoperatively to analyze pedicle violations. 76.4% of 72 screws were placed accurately. Most pedicle perforations were seen laterally towards the vertebral artery. Critical breaches [2 mm or narrowing of the transversal foramen occurred in 12.5% of screws; however, no revision surgery for screw displacement was needed in the absence of clinical symptoms. No conversion from percutaneous to open surgery was necessary. It was concluded that percutaneous transpedicular instrumentation of the cervical spine is a surgically demanding technique and should be reserved for experienced spine surgeons. The indications are limited to instrumentation-only procedures or in combination with anterior treatment, but with the potential to minimize access-related morbidity.

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Evaluation of Extracranial Vertebral Artery Dissection With Duplex Color-Flow Imaging

Abstract: Extracranial vertebral artery dissections can be diagnosed noninvasively with duplex color-flow imaging. It is therefore a useful method for early diagnosis and follow-up examination.

Cited by 98 publications

References 27 publications

What does Doppler Ultrasonography Brings to the Diagnosis of Traumatic Vertebral Artery Dissection

What does Doppler Ultrasonography Brings to the Diagnosis of Traumatic Vertebral Artery Dissection

Blunt cervical spine trauma as a cause of spinal cord injury and delayed cortical blindness

Percutaneous instrumentation of the cervical and cervico-thoracic spine using pedicle screws: preliminary clinical results and analysis of accuracy

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