This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Pozzati, E. Articles by Nuzzo, G. Search for Related Content PubMed PubMed Citation Articles by Pozzati, E. Articles by Nuzzo, G. Pubmed/NCBI databases Medline Plus Health Information Carotid Artery Disease

Stroke, Vol 21, 528-531, Copyright © 1990 by American Heart Association

ARTICLES

Long-term follow-up of occlusive cervical carotid dissection

E Pozzati, G Giuliani, N Acciarri and G Nuzzo
Division of Neurosurgery, Bellaria Hospital, Bologna, Italy.

We retrospectively studied 19 cases of occlusive cervical carotid dissection encountered at our hospital between 1974 and 1984 and followed for 5-13 (mean 8.2) years to assess the long-term prognosis of the disease. Five patients had transient ischemic attacks, seven had minor stroke, six had major stroke, and one had epileptic seizures. Angiography demonstrated the typical string sign in 17 cases, a double lumen with occlusion in one, and multiple scalloped narrowings with distal occlusion in the other. Three patients died within 1 month and three remain severely disabled (overall mortality and major morbidity 32%), five have permanent deficits, and seven are neurologically intact; the remaining patient was lost to follow-up. Five patients were treated surgically (two had extracranial-intracranial bypass and three had cervical carotid exploration), and the other 14 were treated medically. The overall rate of reopening was 47% with eight of 10 patients demonstrating recanalization on control angiography and another patient demonstrating recanalization at surgery. These nine patients remain clinically stable on follow-up evaluations. However, vascular abnormalities in the healed arteries were notable and include kinking, fibromuscular dysplasia, dissecting aneurysms, intracranial occlusion, and a residual mural defect.

This article has been cited by other articles:

				M. Arnold, M. G. Bousser, G. Fahrni, U. Fischer, D. Georgiadis, J. Gandjour, D. Benninger, M. Sturzenegger, H. P. Mattle, and R. W. Baumgartner Vertebral Artery Dissection: Presenting Findings and Predictors of Outcome Stroke, October 1, 2006; 37(10): 2499 - 2503. [Abstract] [Full Text] [PDF]

				E. Touze, J.-Y. Gauvrit, T. Moulin, J.-F. Meder, S. Bracard, and J.-L. Mas Risk of stroke and recurrent dissection after a cervical artery dissection: A multicenter study Neurology, November 25, 2003; 61(10): 1347 - 1351. [Abstract] [Full Text] [PDF]

				D. Milhaud, G. R. de Freitas, G. van Melle, and J. Bogousslavsky Occlusion Due to Carotid Artery Dissection: A More Severe Disease Than Previously Suggested Arch Neurol, April 1, 2002; 59(4): 557 - 561. [Abstract] [Full Text] [PDF]

				A. M. Malek, R. T. Higashida, C. C. Phatouros, T. E. Lempert, P. M. Meyers, W. S. Smith, C. F. Dowd, and V. V. Halbach Endovascular Management of Extracranial Carotid Artery Dissection Achieved Using Stent Angioplasty AJNR Am. J. Neuroradiol., July 1, 2000; 21(7): 1280 - 1292. [Abstract] [Full Text] [PDF]

				J. G. Calaitges and N. Deshmukh Spontaneous Carotid Artery Dissection: Case Reports and Review of the Literature Vascular and Endovascular Surgery, November 1, 1996; 30(6): 473 - 479. [Abstract] [PDF]

				J. Srinivasan, D. W. Newell, M. Sturzenegger, M. R. Mayberg, and H.R. Winn Transcranial Doppler in the Evaluation of Internal Carotid Artery Dissection Stroke, July 1, 1996; 27(7): 1226 - 1230. [Abstract] [Full Text]