Recurrent ischemic events in two patients with painless vertebral artery dissection.

McCormick, G F; Halbach, Van V.

doi:10.1161/01.str.24.4.598

Cited by 27 publications

(8 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recurrent CAD was revealed by a TIA in 1 patient and by cervical pain in 2. These findings suggest that a new angiography should be performed in patients who complain of recurrent cervical pain after CAD; in the future, angiography might be replaced by nontraumatic investigations of cervical arteries such as dynamic CT scans, MRI and magnetic resonance angiography; how ever, these procedures may be negative in CADs [29,30], The cumulative rate of recurrent CAD in our study was close to that of Schievink et al [20] despite a different definition of recurrent CAD. Schievink et al [20] found a higher risk of recurrent CAD within the first month of onset.…”

Section: Discussionsupporting

confidence: 82%

Follow-Up of Patients with History of Cervical Artery Dissection

Leys¹,

Moulin

Stojkovic³

et al. 1995

Cerebrovasc Dis

132

View full text Add to dashboard Cite

The rate of recurrent stroke after cervical artery dissection (CAD) remains unknown. The aim of this study was to evaluate the rate of recurrent stroke in the same territory in patients who were discharged alive after CAD. The secondary aims were to evaluate the rate of death, any stroke or transient ischemic attacks (TIA), recurrent CAD, reopening and residual headache or cervical pain. We contacted 110 consecutive patients with angiographically proven CAD who were discharged alive after CAD. Five of the 110 patients (4.5%) were lost to follow-up. The 105 remaining patients shared a total of 110 CAD (67 carotid, 43 vertebral). The median duration of follow-up was 36 months. Ninety-two patients had no event and 5 died 1–7 years after CAD. Two patients had a recurrent stroke and 3 had TIA in the territory of the previously dissected vessel; 3 had a recurrent dissection of the same vessel, revealed by TIA in 1 and isolated cervical pain in 2. Twenty-one patients had residual headache or cervical pain. In 90 patients who underwent a second angiography, reopening occurred in 52 (partial in 2) and an aneurysm in 5. The risk of recurrent stroke remains low in patients discharged alive after CAD. One of the most frequent sequelae is residual headache.

show abstract

Section: Discussionsupporting

confidence: 82%

Follow-Up of Patients with History of Cervical Artery Dissection

Leys¹,

Moulin

Stojkovic³

et al. 1995

Cerebrovasc Dis

132

View full text Add to dashboard Cite

show abstract

“…The value of magnetic resonance angiography combined with conventional MRI to detect cervical artery dissection is being assessed. 20 ' 21 This study further demonstrated that dynamic CT scan is a sensitive neuroimaging procedure for confirming the presence of the mural hematoma, but it needs to be directed by prior angiography.…”

Section: Discussionmentioning

confidence: 68%

Magnetic resonance imaging and dynamic CT scan in cervical artery dissections.

Züber

Meary

Méder

et al. 1994

Stroke

127

View full text Add to dashboard Cite

The typical magnetic resonance imaging picture of arterial dissection, namely, a narrowed eccentric signal void surrounded by a semilunar signal hyper-intensity (corresponding to the mural hematoma) on T1- and T2-weighted images, has been repeatedly reported, but the sensitivity of magnetic resonance imaging for the diagnosis of cervical dissection is poorly known. Another technique, dynamic computed tomography, may provide evidence of mural hematoma, but there has been no systematic evaluation of this technique. The aims of this study were to assess both the sensitivity of routine 0.5-T magnetic resonance imaging for the detection of a typical picture of cervical artery dissection and the value of dynamic computed tomographic scans to provide evidence of dissecting hematoma. Fifteen consecutive patients with angiographically confirmed extracranial internal carotid (n = 9) or vertebral (n = 10) dissections were studied using a standardized 0.5-T spin-echo magnetic resonance imaging protocol with axial slices. Twelve of these patients had dynamic computed tomographic scans at the site of the dissection suggested by angiography. A typical magnetic resonance imaging picture of cervical artery dissection was observed in 12 of 15 (80%) patients and in 13 of 19 (68%) dissected vessels. The sensitivity of magnetic resonance imaging was higher in internal carotid (78%) than in vertebral (60%) dissections and in stenotic-type dissections (85%) than in occlusive or aneurysmal-type dissections. The dynamic computed tomographic scan showed the mural hematoma in 11 of the 12 (92%) patients and in 12 of 15 (80%) dissected vessels. Routine 0.5-T magnetic resonance imaging with axial slices is a sensitive technique for the diagnosis of dissection, but in about 20% of patients with cervical artery dissection magnetic resonance imaging will demonstrate no typical abnormality. Dynamic computed tomographic scans are a sensitive neuroimaging procedure to confirm the presence of the mural hematoma, but it needs to be directed by prior angiography.

show abstract

“…10 18 22-26 An eccentric signal void surrounded by a semilunar hyperintensity on SE images was considered characteristic for a mural haematoma 38. This holds true if flow related signal increases due to time of flight effects at entry slices and even echo rephasing phenomena have been excluded by adequate slice positioning or radiofrequency presaturation schemes.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance angiographic and clinical features of extracranial vertebral artery dissection

Auer

Felber

Schmidauer

et al. 1998

Journal of Neurology, Neurosurgery & Psychiatry

111

View full text Add to dashboard Cite

Objectives-Clinical data and neuroradiological findings of 19 patients with 20 vertebral artery dissections were analysed to describe the features of time of flight magnetic resonance angiography (MRA) for the diagnosis and follow up of this vascular disorder. Methods-All patients underwent a combined MRI and MRA protocol with 1.5 T scanners, using a three dimensional flow compensated gradient echo sequence for MRA. Duplex sonography was performed on all patients and selective angiography was available from 17 vertebral artery dissections. Results-MRI showed ischaemic lesions of the brain in 18 of 19 patients (95%). In the acute and subacute stage, MRA detected signal abnormalities within the dissected vertebral artery in 94% (16/17) and MRI was specific for a dissection in 29% (5/17). Sensitivity of selective angiography was 100% and specificity was 35% (6/17). Combination of the results of both methods increased the specificity to 50%. Duplex sonography was sensitive in 79% (15/19), but lacked specific results. Follow up magnetic resonance in 16 patients showed recanalisation of the dissected vessel in 10 (63%), persistent occlusion in five (31%), and a dissecting aneurysm in one (6%) patient. Conclusions-Magnetic resonance improves the triage for selective angiography and discloses complementary information for the diagnosis of vertebral artery dissection. If magnetic resonance identifies a double lumen or a mural haematoma with a stenosis or aneurysmal dilatation, invasive procedures can be omitted. (J Neurol Neurosurg Psychiatry 1998;64:474-481)

show abstract

Recurrent ischemic events in two patients with painless vertebral artery dissection.

Cited by 27 publications

References 28 publications

Follow-Up of Patients with History of Cervical Artery Dissection

Follow-Up of Patients with History of Cervical Artery Dissection

Magnetic resonance imaging and dynamic CT scan in cervical artery dissections.

Magnetic resonance angiographic and clinical features of extracranial vertebral artery dissection

Contact Info

Product

Resources

About