engleski

The Dissections of Craniocervical Arteries

The dissection of craniocervical arteries (carotid and vertebral) is sudden lesions of the arterial wall. They are infrequent cause of cerebral stroke, more often in younger age and in women. In majority of cases, the cause and pathogenesis of dissection are not clarified. Dissections are generally divided into two groups: spontaneous and traumatic. Often multivessel dissections can be 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. Spontaneous dissections were found in six and posttraumatic in two subjects. Dissections involved internal carotid artery in four, vertebral artery in two patients. One patient had dissection of both internal carotid and vertebral arteries on ipsilateral side and one patient, together with internal carotid artery dissection showed an intracranial aneurysm. Two patients were operated, five treated with anticoagulants and one with suppressors of platelet aggregation. Following treatment six patients (one operated and five treated with anticoagulants) showed partial recovery of neurological defects together with an improvement of ultrasound finding of dissected arteries. In one patient, following operation, stroke developed with deterioration of motoric deficit. Last patient, treated only with suppressors of platelet aggregation, was readmitted three months lather due to a newly developed stroke and soon died. The, dissections of craniocervical arteries are infrequent but important cause of stroke, especially in younger population. It is prerequisite to recognize this disease by clinical examination, to perform non-aggressive ultrasound and than radiological examinations to verify clinical diagnosis. Risk factors should be minimized, anticoagulant treatment started as soon as possible in order to decrease the chance of heavy stroke and lethal outcome.

craniocervical artery dissections

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