engleski

Dissection of the craniocervical artery

Dissections of the craniocervical arteries (carotid and vertebral) are acute disruptions of the arterial wall. T'hey are a relatively uncommon cause of stroke in general population, but more commonly are the cause of stroke in younger patients, particularly women. Dissections arc generally divided into two groups: spontaneous and traumatic. Often multivessel dissections can he seen. We have investigated 8 patients (4 men and 4 women) age 41 to-66 years, with a dissection of the carotid or vertebral artery. Clinical presentation ultrasonographic examination (transcranial color Doppler and color coded duplex sonography of carotid and vertebral arteries) and neuroimaging (CT and DSA) were followed up. Dissections were spontaneous in 6 patients and posttraumatic in 2 cases. Common clinical manifestations included headache, pain in the neck and focal cerebral symptoms. Seven patients were hypertensive, 3 had hyperlipoproteinemia and 2 were diabetics. Five patients had the dissection of the internal carotid artery, 2 of the vertebral artery and one patient had ipsilateral dissection of the carotid and vertebral] artery. One patient with the dissection of the internal artery also had an intracranial aneurysm. Two patients were treated operatively, 5 with anticoagulation therapy and one with antithrombotic therapy. In follow up after received therapy, 6 patients had partial clinical improvement and improvement in ultrasonographic findings in the dissected arteries. One patient had stroke after surgery with deterioration of neurological deficit. One patient which was treated only with antithrombotic therapy, after 3 months had recurrent fatal stroke. Early clinical, noninvasive ultrasound and radiological detection of craniocervical artery dissection is necessary. Immediate anticoagulation therapy must be introduced in order to minimise morbidity and mortality due to this condition.

cervical artery dissection ; color doppler ; neuroimaging

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