Ultrasound Diagnosis of Cervical Artery Dissection

Baumgartner, Ralf W.

doi:10.1159/000092386

Cited by 33 publications

(25 citation statements)

References 35 publications

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“…The characteristics of our study population resembled that of most previous single-as well as multicenter studies, with an average age in the mid-forties [14][15][16], the male preponderance [14,15,21], the higher rate of ICAD than VAD [14,21], and the rate of occluded CeAD [15,22]. Likewise, the rate of detected mural hematomas (i.e., 31%) and intima flap (i.e., 10.5%) was similar to reported ultrasound studies [17].…”

Section: Discussionsupporting

confidence: 84%

“…Both reviewers assessed the presence or absence of the following ultrasound findings (at baseline and each follow-up examination) applying criteria as described in prior research: (i) mural hematoma [16,17], (ii) intimal flap [17], (iii) double lumen [17,18], (iv) dissecting aneurysm [17], and (v) occlusion. For the latter, we adapted the definition used in prior research (i.e., absence of detectable flow within the former lumen, isoechogenic or hypoechogenic, homogenous, or inhomogenous material within the former lumen, indirect signs attributable to pre-occlusion and post-occlusion hemodynamic alterations, detection of a so-called stump signal proximal to the occlusion) [5] and applied it also for VA occlusion.…”

Section: Review Of Dusmentioning

confidence: 99%

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Clinical Usefulness of Serial Duplex Ultrasound in Cervical Artery Dissection Patients

et al. 2020

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Purpose: To study the clinical usefulness of serial color-coded duplex ultrasound (DUS) examinations in cervical artery dissection (CeAD) patients. Methods: Single-center, CeAD registry-based re-review of serial, routine DUS exams in consecutive CeAD patients treated at the Stroke Center Basel, Switzerland (2009. Two experienced raters reassessed all DUS for the occurrence of new arterial findings during follow-up, that is. (i) recanalization of the dissected artery (if occluded at baseline), (ii) delayed occlusion of a patent dissected artery, and (iii) recurrent CeAD. We studied whether these new arterial findings were associated with clinical symptoms. Results: In 94 CeAD patients (n = 40 female [42.6%], median age 46 years [interquartile range (IQR) 36.2-53]), 506 DUS examinations were reviewed covering a median length of follow-up of 54.1 weeks (IQR 30.5-100.5). In total, 105 dissected arteries were detected, of which 27 (25.7%) were occluded. In 28/94 patients (29.8%), 31 new arterial findings were recorded, which were associated with clinical symptoms in 9/31 (30%) patients. Recanalization of occluded CeAD was observed in 22/27 (81.5%) arteries and occurred in 20/22 arteries within 3 months. In 4/22 patients (18.2%), recanalization was associated with clinical symptoms (ischemic events [n = 2], pure local symptoms [n = 2]). Delayed occlusions were observed in 4/78 (5.1%) dissected arteries patent at baseline. All were clinically asymptomatic and occurred within 14 days from baseline. Recurrent CeAD (all symptomatic) occurred in 5 previously non-dissected arteries. Conclusion: In CeAD patients, follow-up DUS identified new arterial findings, of which several were associated with clinical symptoms: we found that about 1 of 5 recanalizations were associated with clinical symptoms, of whom half were ischemic symptoms. Further, delayed occlusions occurred in patients with no or mild stenosis at baseline and were asymptomatic. This study emphasizes the potential importance of repeated DUS in CeAD particularly in the early phase of up to 4 weeks.

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Section: Discussionsupporting

confidence: 84%

Section: Review Of Dusmentioning

confidence: 99%

Clinical Usefulness of Serial Duplex Ultrasound in Cervical Artery Dissection Patients

et al. 2020

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“…This technique assesses a reduction of blood flow with good sensitivity only with stenosis > 50% downstream; ultrasound investigation has poor sensitivity in non-stroke patients with isolated Horner syndrome [15]. B-mode images visualize the arterial wall and the surrounding tissue: they may identify the double lumen but with poor sensitivity and only when located in the proximal extracranial carotid segment [16]. MRA evaluates the vessel wall and is able to detect intramural hematoma despite vessel occlusion: axial MRA T1-weighted imaging with fat suppression allows an optimal discrimination between intramural hematoma and perivascular tissue [17].…”

Section: Discussionmentioning

confidence: 99%

Carotid dissection mimicking a new attack of cluster headache

et al. 2013

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BackgroundSymptomatic cluster headache (CH) secondary to internal carotid artery dissection (ICAD) has been frequently reported, however, as far as we know, the coexistence of episodic CH and acute symptomatic CH secondary to ICAD has not.Case reportA 39 year-old man, affected by episodic CH since the age of 19, presented an atypical headache associated with his usual autonomic symptoms. After a series of negative tests, MRA eventually revealed dissection of the right distal internal carotid artery.Discussion and conclusionsThe coexistence of episodic CH and acute CH symptomatic of ICAD in our patient suggests that, at least in some cases, CH and ICAD may be different expressions of a common underlying cause: hidden vessel wall damage. When risk factors and the change - though partial - of clinical features suggest symptomatic cases, CH patients have to be strictly monitored over time. Given the lack of a gold standard investigation for dynamic diseases such as dissections, these patients require multimodal diagnostic investigation over time, even in cases where exams are normal at onset.

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“…But the imaging diagnostic criteria have still not reached a consensus due to different available methods. In this study, we used the standard ultrasonography (US) for diagnosing ex-vertebral artery dissection, [1] which included multiple segmental intramural hematoma, the membranous tube cavity of the echo, double cavity structure, and irregular artery stenosis. Of these, only 1 or any 1 can be a definitive diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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

Yang

Ran

2017

Medicine

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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.

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Ultrasound Diagnosis of Cervical Artery Dissection

Cited by 33 publications

References 35 publications

Clinical Usefulness of Serial Duplex Ultrasound in Cervical Artery Dissection Patients

Clinical Usefulness of Serial Duplex Ultrasound in Cervical Artery Dissection Patients

Carotid dissection mimicking a new attack of cluster headache

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

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