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European Radiology
Erschienen in: European Radiology 3/2007

01.03.2007 | Neuro

Carotid and vertebral artery dissections: clinical aspects, imaging features and endovascular treatment

verfasst von: Christine M. Flis, H. Rolf Jäger, Paul S. Sidhu

Erschienen in: European Radiology | Ausgabe 3/2007

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Abstract

Extracranial arterial dissections are a recognised cause of stroke, particularly in young adults. Clinical diagnosis may be difficult, and the classical triad of symptoms is uncommon. Imaging plays a pivotal role in the diagnosis of extracranial arterial dissections, and this review provides a detailed discussion of the relative merits and limitations of currently available imaging modalities. Conventional arteriography has been the reference standard for demonstrating an intimal flap and double lumen, which are the hallmarks of a dissection, and for detecting complications such as stenosis, occlusion or pseudoaneurysm. Noninvasive vascular imaging methods, such as ultrasound (US), magnetic resonance angiography (MRA) and computed tomography angiography (CTA) are increasingly replacing conventional angiography for the diagnosis of carotid and vertebral dissections. Ultrasound provides dynamic and “real-time” information regarding blood flow. Source data of MRA and CTA and additional cross-sectional images can provide direct visualisation of the mural haematoma and information about the vessel lumen. Anticoagulation to prevent strokes is the mainstay of medical treatment, but randomised trials to define the optimal treatment regime are lacking. Surgery has a limited role in management of dissections, but endovascular procedures are gaining importance for treatment of complications and if medical management fails.
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Metadaten
Titel
Carotid and vertebral artery dissections: clinical aspects, imaging features and endovascular treatment
verfasst von
Christine M. Flis
H. Rolf Jäger
Paul S. Sidhu
Publikationsdatum
01.03.2007
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 3/2007
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-006-0346-7

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