(Stroke. 1996;27:290-295.)
© 1996 American Heart Association, Inc.
Articles |
Evaluation of Extracranial Vertebral Artery Dissection With Duplex Color-Flow Imaging
From the Department of Neurology and Clinical Neurophysiology, Akademisches Lehrkrankenhaus, Städtisches Krankenhaus München-Bogenhausen, Munich, Germany.
Correspondence to Eva Bartels, MD, Department of Neurology and Clinical Neurophysiology, Städtisches Krankenhaus München-Bogenhausen, Englschalkinger Str 77, 81925 Munich, Germany.
Background and Purpose We describe the diagnostic potential of duplex color-flow imaging in the evaluation of extracranial vertebral artery dissection.
Methods Twenty patients with 24 extracranial vertebral artery dissections (four bilateral) were examined with duplex ultrasonography over a period of 6 years. Color-flow imaging was carried out in 16 of these patients. In 15 patients (75%), the dissection was temporally related to trauma. Angiography was available in 18 patients, confirming the diagnosis.
Results In 15 patients, the diagnosis was primarily established with ultrasonography. Five patients with a dissection were referred for follow-up color-flow examinations. Six vertebral arteries were dissected at the origin or in the proximal V1 segment, one in the distal V2 segment, and one at the atlas loop. In contrast to other studies, the most frequent localization of the dissection in our patients was the region between the V1 and V2 segments (n=16), where the most typical dissection site was the entrance of the artery into the transverse foramen of the C6 vertebra (n=11). Typical ultrasonographic findings were irregular stenosis, dissecting membrane with true and false lumen, localized increase in diameter of the artery, pseudoaneurysm, intramural hematoma, and tapering stenosis with distal occlusion. In follow-up examination, a good regression of pathological findings was found in 17 dissections (70.8%). Two occlusions were completely recanalized.
Conclusions Extracranial vertebral artery dissections can be diagnosed noninvasively with duplex color-flow imaging. It is therefore a useful method for early diagnosis and follow-up examination.
Key Words: dissection • duplex scanning • ultrasonics • vertebral artery
This article has been cited by other articles:
 |
|
 |
|
  M. H. Rodallec, V. Marteau, S. Gerber, L. Desmottes, and M. Zins Craniocervical Arterial Dissection: Spectrum of Imaging Findings and Differential Diagnosis1 RadioGraphics, October 1, 2008; 28(6): 1711 - 1728. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Bartels, Y. Yakushiji, M. Yasaka, T. Takada, and K. Minematsu Sonographic Findings in Dissection of Extracranial Brain-Supplying Arteries * Reply J. Ultrasound Med., February 1, 2006; 25(2): 289 - 291. [Full Text] [PDF]
|
|
|
|
 |
|
 K. Saito, K. Kimura, K. Nagatsuka, K. Nagano, K. Minematsu, S. Ueno, and H. Naritomi Vertebral Artery Occlusion in Duplex Color-Coded Ultrasonography Stroke, May 1, 2004; 35(5): 1068 - 1072. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Beletsky, Z. Nadareishvili, J. Lynch, A. Shuaib, A. Woolfenden, and J. W. Norris Cervical Arterial Dissection: Time for a Therapeutic Trial? Stroke, December 1, 2003; 34(12): 2856 - 2860. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Sakaguchi, K. Kitagawa, H. Hougaku, H. Hashimoto, Y. Nagai, H. Yamagami, T. Ohtsuki, N. Oku, K. Hashikawa, K. Matsushita, et al. Mechanical compression of the extracranial vertebral artery during neck rotation Neurology, September 23, 2003; 61(6): 845 - 847. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J M de Bray, I Penisson-Besnier, F Dubas, and J Emile Extracranial and intracranial vertebrobasilar dissections: diagnosis and prognosis J. Neurol. Neurosurg. Psychiatry, July 1, 1997; 63(1): 46 - 51. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. B Blunt and C. Galton Cervical carotid or vertebral artery dissection BMJ, January 25, 1997; 314(7076): 243 - 243. [Full Text]
|
|