nach oben

European Radiology

Erschienen in:

01.04.2007 | Neuro

Dissection of the V4 segment of the vertebral artery: clinicoradiologic manifestations and endovascular treatment

verfasst von: Woong Yoon, Jeong Jin Seo, Tae Sun Kim, Huy M. Do, Mahesh V. Jayaraman, Michael P. Marks

Erschienen in: European Radiology | Ausgabe 4/2007

Einloggen, um Zugang zu erhalten

Abstract

Intracranial vertebral artery (VA) dissection has three clinical presentations: ischemia, hemorrhage, and mass effect. Imaging findings of intracranial VA dissections vary according to clinical presentation. Irregular stenosis or occlusion of the VA is the most common finding in patients with posterior fossa infarction, whereas a dissecting aneurysm is the main feature in those with acute subarachnoid hemorrhage. A chronic, giant, dissecting aneurysm can cause mass effect on the brain stem or cranial nerves, as well as distal embolism. Magnetic resonance imaging is useful for detection of intramural hematomas and intimal flaps, both of which are diagnostic of VA dissection. Multidetector computed tomography angiography is increasingly used for diagnosis of VA dissection. Catheter angiography is still beneficial for evaluation of precise endoluminal morphology of the dissection before surgical or endovascular intervention. Endovascular treatment is now considered a major therapeutic option for patients with a ruptured dissecting aneurysm or a chronic dissecting aneurysm. Anticoagulation therapy is currently considered the initial treatment of choice in patients with posterior circulation ischemic symptoms. Endovascular treatment, such as stent-assisted angioplasty or coil occlusion at the dissection site, can be performed in selected patients with posterior fossa ischemic symptoms.

Schievink WI (2001) Spontaneous dissection of the carotid and vertebral arteries. N Engl J Med 344:898–906PubMedCrossRef

Tay KY, U-King-Im JM, Trivedi RA et al (2005) Imaging the vertebral artery. Eur Radiol 15:1329–1343PubMedCrossRef

Standring S, Crossman AR (eds) (2005) Neuroanatomy. Gray’s anatomy: the anatomical basis of clinical practice, 39th edn. Elsevier, London, pp 298–300

Wilkinson IM (1972) The vertebral artery: extracranial and intracranial structure. Arch Neurol 27:392–396PubMed

Mokri B, Houser OW, Sandok BA, Piepgras DG (1988) Spontaneous dissections of the vertebral arteries. Neurology 38:880–885PubMed

Hasan I, Wapnick S, Tenner MS, Couldwell WT (2002) Vertebral artery dissection in children: a comprehensive review. Pediatr Neurosurg 37:168–177PubMedCrossRef

Pelkonen O, Tikkakoski T, Leinonen S et al (2003) Extracranial internal carotid and vertebral artery dissections: angiographic spectrum, course and prognosis. Neuroradiology 45:71–77PubMed

Brandt T, Grond-Ginsbach C (2002) Spontaneous cervical artery dissection: from risk factors toward pathogenesis. Stroke 33:657–658PubMed

Thanvi B, Munshi SK, Dawson SL, Robinson TG (2005) Carotid and vertebral artery dissection syndromes. Postgrad Med J 81:383–388PubMedCrossRef

10.

Grau AJ, Brandt T, Buggle F et al (1999) Association of cervical artery dissection with recent infection. Arch Neurol 56:851–856PubMedCrossRef

11.

Schievink WI, Wijdicks EF, Kuiper JD (1998) Seasonal pattern of spontaneous cervical artery dissection. J Neurosurg 89:101–103PubMedCrossRef

12.

Mizutani T, Miki Y, Kojima H, Suzuki H (1999) Proposed classification of nonatherosclerotic cerebral fusiform and dissecting aneurysms. Neurosurgery 45:253–260PubMedCrossRef

13.

Mizutani T, Kojima H, Asamoto S, Miki Y (2001) Pathological mechanism and three-dimensional structure of cerebral dissecting aneurysms. J Neurosurg 94:712–717PubMed

14.

Yamada M, Miyasaka Y, Yagishita S, Fujii K (2003) Dissecting aneurysm of the intracranial vertebral artery associated with proximal focal degeneration of the elastica: a comparative pathological study of the vertebral artery in patients with and without aneurysms. Surg Neurol 60:431–437PubMedCrossRef

15.

Yonas H, Agamanolis D, Takaoka Y, White RJ (1977) Dissecting intracranial aneurysms. Surg Neurol 8:407–415PubMed

16.

Endo S, Nishijima M, Nomura H, Takaku A, Okada E (1993) A pathological study of intracranial posterior circulation dissecting aneurysms with subarachnoid hemorrhage: report of three autopsied cases and review of the literature. Neurosurgery 33:732–738PubMedCrossRef

17.

Caplan LR, Baquis GD, Pessin MS et al (1988) Dissection of the intracranial vertebral artery. Neurology 38:868–877PubMed

18.

Caplan LR, Biousse V (2004) Cervicocranial arterial dissections. J Neuroophthalmol 24:299–305PubMed

19.

Krings T, Piske RL, Lasjaunias PL (2005) Intracranial arterial aneurysm vasculopathies: targeting the outer vessel wall. Neuroradiology 47:931–937PubMedCrossRef

20.

Schubiger O, Valavanis A, Hayek J (1980) Computed tomography in cerebral aneurysms with special emphasis on giant intracranial aneurysms. J Comput Assist Tomograph 4:24–32CrossRef

21.

Schubiger O, Valavanis A, Wichmann W (1987) Growth-mechanism of giant intracranial aneurysms: demonstration by CT and MR imaging. Neuroradiology 29:266–271PubMedCrossRef

22.

de Bray JM, Penisson-Besnier I, Dubas F, Emile J (1997) Extracranial and intracranial vertebrobasilar dissections: diagnosis and prognosis. J Neurol Neurosurg Psychiatry 63:46–51PubMed

23.

Beletsky V, Nadareishvili Z, Lynch J et al (2003) Cervical artery dissection: time for a therapeutic trial? Stroke 34:2856–2860PubMedCrossRef

24.

Koch S, Air M, Rabinstein A, Reyes-Iglesias Y, Romano JG, Forteza A (2005) Diffusion-weighted magnetic resonance imaging in symptomatic vertebrobasilar atherosclerosis and dissection. Arch Neurol 62:1228–1231PubMedCrossRef

25.

Hoyosa T, Adachi M, Yamaguchi K, Haku T, Kayama T, Kato T (1999) Clinical and neuroradiological features of intracranial vertebrobasilar artery dissection. Stroke 30:1083–1090

26.

Kameda W, Kawanami T, Kurita K et al (2004) Lateral and medial medullary infarction: a comparative study analysis of 214 patients. Stroke 35:694–699PubMedCrossRef

27.

Yoshimoto Y, Wakai S (1997) Unruptured intracranial vertebral artery dissection. Stroke 28:370–374PubMed

28.

Nakagawa K, Touho H, Morisako T et al (2000) Long-term follow-up study of unruptured vertebral artery dissection: clinical outcomes and serial angiographic findings. J Neurosurg 93:19–25PubMed

29.

Yamada M, Kitahara T, Kurata A, Fujii K, Miyasaka Y (2004) Intracranial vertebral artery dissection with subarachnoid hemorrhage: clinical characteristics and outcomes in conservatively treated patients. J Neurosurg 101:25–30PubMed

30.

Mizutani T, Aruga T, Kirino T, Miki Y, Saito I, Tsuchida T (1995) Recurrent subarachnoid hemorrhage from untreated ruptured vertebrobasilar dissecting aneurysms. Neurosurgery 36:905–913PubMedCrossRef

31.

Shah GV, Quint DJ, Trobe JD (2004) Magnetic resonance imaging of suspected cervicocranial arterial dissections. J Neuroophthalmol 24:315–318PubMed

32.

Mascalchi M, Bianchi MC, Mangiafico S, et al (1997) MRI and MR angiography of vertebral artery dissection. Neuroradiology 39:329–340PubMedCrossRef

33.

Gelal FM, Kitis O, Calli C, Yunten N, Vidinli BD, Uygur M (2004) Craniocervical artery dissection: diagnosis and follow-up with MR imaging and MR angiography. Med Sci Monit 10:MT109–MT116PubMed

34.

Auer A, Felber S, Schmidauer C, Waldenberger P, Aichner F (1998) Magnetic resonance angiographic and clinical features of extracranial vertebral artery dissection. J Neurol Neurosurg Psychiatry 64:474–481PubMedCrossRef

35.

Okumura A, Araki Y, Nishimura Y et al (2001) The clinical utility of contrast-enhanced 3D MR angiography for cerebrovascular disease. Neurol Res 23:767–771PubMedCrossRef

36.

Chen CJ, Tseng YC, Lee TH, Hsu HL, See LC (2004) Multisection CT angiography compared with catheter angiography in diagnosing vertebral artery dissection. AJNR Am J Neuroradiol 25:769–774PubMed

37.

Kitanaka C, Sasaki T, Eguchi T, Teraoka A, Nakane M, Hoya K (1994) Intracranial vertebral artery dissections: clinical, radiological features, and surgical considerations. Neurosurgery 34:620–627PubMedCrossRef

38.

Kurata A, Ohmono T, Miyasaka Y, Fujii, K, Kan S, Kitahara T (2001) Coil embolization for the treatment of ruptured dissecting vertebral aneurysms. AJNR Am J Neuroradiol 22:11–18PubMed

39.

Inamasu J, Nakamura Y, Saito R et al (2003) Endovascular treatment of ruptured vertebral artery dissection in the acute stage. Cerebrovasc Dis 16:306–308PubMedCrossRef

40.

Rabinov JD, Hellinger FR, Morris PP, Ogilvy CS, Putman CM (2003) Endovascular management of vertebrobasilar dissecting aneurysms. AJNR Am J Neuroradiol 24:1421–1428PubMed

41.

Albuquerque FC, Fiorella DJ, Han PP, Deshmukh VR, Kim LJ, McDougall CG (2005) Endovascular management of intracranial vertebral artery dissecting aneurysms. Neurosurg Focus 18:E3PubMed

42.

Ramgren B, Cronqvist M, Rommer B, Brandt L, Holtas S, Larsson EM (2005) Vertebrobasilar dissection with subarachnoid hemorrhage: a retrospective study of 29 patients. Neuroradiology 47:97–104PubMedCrossRef

43.

Sugiu K, Tokunaga K, Watanabe K et al (2005) Emergent endovascular treatment of ruptured vertebral artery dissecting aneurysms. Neuroradiology 47:158–164PubMedCrossRef

44.

Yuki I, Murayama Y, Vinuela F (2005) Endovascular management of dissecting vertebrobasilar artery aneurysms in patients presenting with acute subarachnoid hemorrhage. J Neurosurg 103:649–655PubMed

45.

Halbach VV, Higashida RT, Dowd CF et al (1993) Endovascular treatment of vertebral artery dissections and pseudoaneurysms. J Neurosurg 79:183–191PubMed

46.

Tsukahara T, Wada H, Satake K, Yaoita H, Takahashi A (1995) Proximal balloon occlusion for dissecting vertebral aneurysms accompanied by subarachnoid hemorrhage. Neurosurgery 36:914–920PubMedCrossRef

47.

Leibowitz R, Do HM, Marcellus ML, Chang SD, Steinberg GK, Marks MP (2003) Parent vessel occlusion for vertebrobasilar fusiform and dissecting aneurysms. AJNR Am J Neuroradiol 24:902–907PubMed

48.

Yamaura I, Tani E, Yokota M et al (1999) Endovascular treatment of ruptured dissecting aneurysms aimed at occlusion of the dissected site by using Guglielmi detachable coils. J Neurosurg 90:853–856PubMed

49.

Iihara K, Saka N, Murao K et al (2002) Dissecting aneurysms of the vertebral artery: a management strategy. J Neurosurg 97:259–267PubMedCrossRef

50.

Hamada JI, Kai Y, Morioka M, Yano S, Todaka T, Ushio Y (2003) Multimodal treatment of ruptured dissecting aneurysms of the vertebral artery during the acute stage. J Neurosurg 99:960–966PubMed

51.

Otawara Y, Ogasawara K, Ogawa A, Kogure T (2002) Dissecting aneurysms of the bilateral vertebral arteries with subarachnoid hemorrhage: report of three cases. Neurosurgery 50:1372–1375PubMedCrossRef

52.

Mackay CI, Han PP, Albuquerque FC, McDougall CG (2003) Recurrence of a vertebral artery dissecting pseudoaneurysm after successful stent-supported coil embolization: case report. Neurosurgery 53:754–761PubMedCrossRef

53.

Benndorf G, Herbon U, Sollmann WP, Campi A (2001) Treatment of a ruptured dissecting vertebral artery aneurysm with double stent placement: case report. AJNR Am J Neuroradiol 22:1844–1848PubMed

54.

Mehta B, Burke T, Kole M, Bydon A, Seyfried D, Malik G (2003) Stent-within-a-stent technique for the treatment of dissecting vertebral artery aneurysms. AJNR Am J Neuroradiol 24:1814–1818PubMed

55.

Willing SJ, Skidmore F, Donaldson J, Nobo UL, Chernukha K (2003) Treatment of acute intracranial vertebrobasilar dissection with angioplasty and stent placement: report of two cases. AJNR Am J Neuroradiol 24:985–989PubMed

56.

Ahn JY, Chung SS, Lee BH et al (2005) Treatment of spontaneous arterial dissections with stent placement for preservation of the parent artery. Acta Neurochir (Wien) 147:265–273CrossRef

57.

Naito I, Iwai T, Sasaki T (2002) Management of intracranial vertebral artery dissections initially presenting without subarachnoid hemorrhage. Neurosurgery 51:930–938PubMedCrossRef

58.

Cohen JE, Gomori M, Umansky F (2003) Endovascular management of spontaneous bilateral symptomatic vertebral artery dissections. AJNR Am J Neuroradiol 24:2052–2056PubMed

59.

Malek AM, Higashida RT, Phatouros CC et al (2000) Endovascular management of extracranial carotid artery dissection achieved using stent angioplasty. AJNR Am J Neuroradiol 21:1280–1292PubMed

60.

Shin YS, Kim SY, Cho KH, Cho KG (2004) Treatment of vertebral artery dissecting aneurysms presenting with progressive myelopathy. J Clin Neurosci 11:896–898PubMedCrossRef

61.

Katayama Y, Tsubokawa T, Miyazaki S, Furuichi M, Hirayama T, Himi K (1991) Growth of totally thrombosed giant aneurysm within the posterior cranial fossa. Neuroradiology 33:168–170PubMedCrossRef

62.

Hecht ST, Horton JA, Yonas H (1991) Growth of a thrombosed giant vertebral artery aneurysm after parent artery occlusion. AJNR Am J Neuroradiol 12:449–451PubMed

63.

Nagahiro S, Takada A, Goto S, Kai Y, Ushio Y. (1995) Thrombosed growing giant aneurysms of the vertebral artery: growth mechanism and management. J Neurosurg 82:796–801PubMed

64.

Iihara K, Murao K, Sakai N et al (2003) Continued growth of and increased symptoms from a thrombosed giant aneurysm of the vertebral artery after complete endovascular occlusion and trapping: the role of vasa vasorum. J Neurosurg 98:407–413PubMed

Titel: Dissection of the V4 segment of the vertebral artery: clinicoradiologic manifestations and endovascular treatment
verfasst von: Woong Yoon
Jeong Jin Seo
Tae Sun Kim
Huy M. Do
Mahesh V. Jayaraman
Michael P. Marks
Publikationsdatum: 01.04.2007
Verlag: Springer-Verlag
Erschienen in: European Radiology / Ausgabe 4/2007
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-006-0272-8

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Dissection of the V4 segment of the vertebral artery: clinicoradiologic manifestations and endovascular treatment

Abstract

Neu im Fachgebiet Radiologie

S3-Leitlinie zu Pankreaskrebs aktualisiert

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

Wie toxische Männlichkeit der Gesundheit von Männern schadet

Update Radiologie

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2007

Tuberculous adenitis: comparison of CT and MRI findings with histopathological features

Screening for bone metastases: whole-body MRI using a 32-channel system versus dual-modality PET-CT

Multi-Detector row CT urography on a 16-row CT scanner in the evaluation of urothelial tumors

Quantitative contrast-enhanced computed tomography: is there a need for system calibration?

Characterization of focal liver lesions: comparative study of contrast-enhanced ultrasound versus spiral computed tomography

Characterisation of intra-articular soft tissue tumours and tumour-like lesions

Neu im Fachgebiet Radiologie

S3-Leitlinie zu Pankreaskrebs aktualisiert

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

Wie toxische Männlichkeit der Gesundheit von Männern schadet

Update Radiologie