Intramural Hematoma Shape and Acute Cerebral Infarction in Intracranial Artery Dissection: A High-Resolution Magnetic Resonance Imaging Study

Lee, Sang Hun; Jung, Jun‐Sub; Kim, Keon Yeup; Kim, Bum Joon

doi:10.1159/000508027

Cited by 10 publications

(7 citation statements)

References 22 publications

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“…To support our hypothesis, we performed a sub-analysis including patients with or without intramural hematoma (IMH, a pathognomonic marker of SCCAD) (10)(11)(12). Interestingly, 85 (39.5%) cases with SCCAD had IMH; among them, 15 (17.6%) patients had at least one autoimmune disease; 130 (60.5%) cases of SCCAD had no IMH, and 12 (9.2%) patients had at least one autoimmune disease.…”

Section: Autoimmune Disease and The Risk Of Sccadmentioning

confidence: 92%

Association Between Autoimmune Diseases and Spontaneous Cervicocranial Arterial Dissection

Song

Yang

et al. 2022

Front. Immunol.

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A series of biopsies and reports showed autoimmune diseases might be involved in the process of local inflammation related to spontaneous cervicocranial arterial dissection (SCCAD) occurrence. This retrospective case-control study examined the association between SCCADs and autoimmune diseases in patients and control subjects from 2014 to 2020. SCCAD patients and age/sex-matched control subjects were recruited, and clinical data were collected. SCCAD was confirmed by digital subtraction angiography or high-resolution magnetic resonance imaging. The study included 215 SCCAD patients and 430 control subjects. Totally, 135 (62.8%) of the 215 cases were found SCCAD in the anterior circulation, 26 (12.0%) patients involved multiple vessels. Autoimmune disease occurred in 27 (12.6%) cases with SCCAD and 4 (0.9%) control subjects (p<0.001). A conditional multivariable logistic regression model was used to calculate the odds ratio for SCCAD among patients with a history of autoimmune disease, adjusting for hypertension, diabetes, hyperlipidemia, and smoking. After adjustment, autoimmune diseases were associated with SCCAD (p<0.001). After sub-analysis by a similar modeling strategy, significant associations were still observed in different subgroups, such as female group and male group as well as intramural hematoma (IMH) group and Non-IHM group. The association of SCCAD with autoimmune disease suggested that autoimmune mechanisms may be involved in some etiologies of SCCAD.

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Section: Autoimmune Disease and The Risk Of Sccadmentioning

confidence: 92%

Association Between Autoimmune Diseases and Spontaneous Cervicocranial Arterial Dissection

Song

Yang

et al. 2022

Front. Immunol.

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“…Lee's study showed the shape of intramural hematomas was independently associated with cerebral infarction. Proximal dominant intramural hematomas may be more closely associated with the cerebral infarctions than the distal dominant intramural hematomas ( 9 ). In addition, pseudoaneurysms are less common and occur because of partial transection of the artery.…”

Section: Discussionmentioning

confidence: 99%

Case report: Acute ischemic stroke caused by intracranial artery dissection in a patient with skull fractures

Zheng¹,

Luo²,

Zhou³

et al. 2022

Front. Neurol.

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The intracranial artery dissection (IAD) is an uncommon but life-threatening disease. The IAD would develop a significant cerebral infarction due to unrecognized contrecoup brain injury. We report a 53-year-old man fell to develop blunt cerebrovascular injuries (BCVIs) more than 2 months ago. During his rehabilitation, he often had a transient left headache and underwent short-term right limb weakness twice, but he did not care. He was hospitalized again because of suffering right limb weakness for more than 4 h. The brain computed tomography angiography (CTA) showed subtotal occlusion of the left middle cerebral artery M1 segment, and the vascular morphology displayed the IAD. The patient was then treated with balloon dilation and a self-expanding stent. This case highlights that IAD may show delayed onset with no initial typical symptom. By early detecting of abnormal signs and symptoms, serious traumatic brain injury may be avoided.

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“…Aneurysmal protrusion, including dissecting aneurysm and pseudoaneurysms, was de ned as an aneurysm with a vessel diameter exceeding the diameter of the normal distal artery by ≥ 1.5-fold [12] (Figure 1, green arrows in Figure 5, and Figure 6). IMH was de ned as a false lumen lled with hematoma without blood ow, showing iso-or hypersignal shadow on images before angiography [13,14] (red arrows in Figure 3). The degree of wall enhancement of the blood vessels was divided into 3 levels as follows: Level 0, similar to a normal blood vessel wall; Level 1, greater than Level 0 but less than venous wall enhancement; Level 2, similar to or greater than venous wall enhancement.…”

Section: Image Analysismentioning

confidence: 99%

Imaging investigation of cervicocranial artery dissection by using high resolution magnetic resonance VWI and MRA : qualitative and quantitative analysis at different stages

Zhou

Lan

et al. 2022

Preprint

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Background To explore the value of magnetic resonance angiography(MRA) and high resolution magnetic resonance vessel wall imaging(HRMR-VWI) in cervicocranial artery dissection(CCAD) diagnosis and disease staging.On the basis of qualitative evaluation,this study also extract the dynamic changes in vessel wall in different vessel segments to identify imaging indicators for the quantitative evaluation of CCAD. Methods We retrospectively enrolled 33 patients with CCAD（37 branches）with conventional MRA and HRMR-VWI examinations.Two radiologists independently analyzed imaging features of vessel wall and lumen in the different stages,and the typical sign detection of artery dissection were compared between MRA and HRMR-VWI.Then the parameters of vessel wall was quantitatively evaluated by Vesselmass.Results HRMR-VWI revealed typical sign detection of artery dissection in all patients in the acute and subacute stage.Among them,the intimal flap/double lumen sign ditection were more common than the MRA,there was significant difference(P=0.01).MRA revealed typical sign detection of artery dissection in more than half the patients,and the detection was no significant difference at the chronic stage between MRA and HRMR-VWI(P=1.000/1.000/0.761).In the acute and subacute stage, the typical sign detection of artery dissection revealed by HR-MRI was higher than the observations in the chronic stage(P=0.028),while there was no significant difference by MRA(P=0.682/1.000). The relative signal intensity of IMH and wall enhancement, wall thickness index were gradually decreased from the acute stage to the chronic stage;Significant differences were found between the recovered group of chronic stage and the acute stage(P＜0.05),but it is no significant difference between the recovered group of chronic stage and the acute stage(p=1.000、0.061).Conclusions As the only noninvasive imaging technology, HRMR-VWI displays the structure of the vessel wall in vivo, showing not only excellent performance in the early diagnosis of CCAD, but also describing the dynamic changes in the qualitative and quantitative characteristics of vessel wall. It also helps to guide the disease course, staging, prognosis, and treatment of CCAD.Although the diagnostic efficacy of MRA was not as good as HRMR-VWI, it should be the first choice of method for routine examination in evaluating CCAD, especially at the chronic stage of CCAD.

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Intramural Hematoma Shape and Acute Cerebral Infarction in Intracranial Artery Dissection: A High-Resolution Magnetic Resonance Imaging Study

Cited by 10 publications

References 22 publications

Association Between Autoimmune Diseases and Spontaneous Cervicocranial Arterial Dissection

Association Between Autoimmune Diseases and Spontaneous Cervicocranial Arterial Dissection

Case report: Acute ischemic stroke caused by intracranial artery dissection in a patient with skull fractures

Imaging investigation of cervicocranial artery dissection by using high resolution magnetic resonance VWI and MRA : qualitative and quantitative analysis at different stages

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