The advantage of ultrasonography in the diagnosis of extracranial vertebral artery dissection

Abstract

Rationale:With the rapid development in technology of vascular imaging, the detection of artery dissection is also gradually increasing. Cervical artery dissection, including carotid artery and vertebral artery dissection, is associated in at least 20% of young adult patients with stroke. So, the diagnosis of cervical artery has become a great challenge.Patient concerns:We reported 2 patients who complained of dizziness and pain, the findings of US confirmed the presence of extracranial vertebral artery dissection.Diagnoses:The floating membrane in lumen and intramural hematoma were found in US, consistent with vertebral artery dissection, whereas DSA revealed no typical sign of artery dissection.Interventions:In order to the definite diagnosis we persuaded the patients to undergo DSA, but there was no strong evidence on the diagnosis of vertebtal artery dissection.Outcomes:The patients were diagnosed of vertebral artery dissection by US.Lessons:US show more advantages in diagnosis of extracranial vertebral artery dissection, might even be considered as the first choice.

Extracranial vertebral artery dissection

“…The presence of any one of these standard findings can be used to make a definitive diagnosis. [ 6 ] The location of dissection is defined on the basis of the standard anatomical categories. [ 7 ] The V1 segment runs from the origin to C6; the V2 segment, from C6 to C2; the V3 segment, from C2 to the dura; and the V4 segment, from the dura to the basilar artery.…”

Vertebrobasilar and internal carotid arteries dissection in 188 patients

“…MRI was applied in all patients with dissections, but also CTA, DSA, and Doppler sonography occasionally [14,41,57,[99][100][101]. Occlusion was seen in up to 18%, and a <50% stenosis in 73%.…”