Spontaneous Intracranial Artery Dissection causing Subarachnoid Hemorrhage: Importance of Short-Term Surveillance

2021 ◽  
pp. 194187442110070
Author(s):  
Mougnyan Cox ◽  
Joshua Thatcher ◽  
Rory Mayer ◽  
Ike Thacker ◽  
Rachel Pearson ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Morphological Change ◽  
Artery Dissection ◽  
Intracranial Artery ◽  
Short Term ◽  
Acute Period ◽  
Diagnosis And Management ◽  
High Propensity ◽  
Intracranial Artery Dissection

Hemorrhagic intracranial artery dissections are unstable lesions, with a high propensity for rebleeding (up to 40%) in the acute period. Imaging plays an important role in the diagnosis and management of intracranial artery dissections. In this paper, we describe 2 cases in which the dissected intracranial artery underwent rapid morphological change within 3 days or less, highlighting the importance of short-term follow-up imaging in patients with these hemorrhagic lesions.

scholarly journals Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection

2015 ◽  
Vol 14 (6) ◽  
pp. 640-654 ◽  
Author(s):  
Stéphanie Debette ◽  
Annette Compter ◽  
Marc-Antoine Labeyrie ◽  
Maarten Uyttenboogaart ◽  
Tina M Metso ◽  
...  
Keyword(s):  
Artery Dissection ◽  
Intracranial Artery ◽  
Diagnosis And Management ◽  
Intracranial Artery Dissection

scholarly journals Pathological Study of Intracranial Artery Dissection with Subarachnoid Hemorrhage

1997 ◽  
Vol 25 (3) ◽  
pp. 169-176 ◽  
Author(s):  
Shunro ENDO ◽  
Michiyasu TAKABA ◽  
Tsuneaki OGIICHI ◽  
Masanori KURIMOTO ◽  
Michiharu NISHIJIMA ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Artery Dissection ◽  
Intracranial Artery ◽  
Pathological Study ◽  
Intracranial Artery Dissection

Abstract TP86: Clinical Significance of Gadolinium Enhancement in Non-Hemorrhagic Intracranial Artery Dissection

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Yukishige Hashimoto ◽  
Toshinori Matsushige ◽  
Koji Shimonaga ◽  
Hiroki Takahashi ◽  
Chiaki Ono ◽  
...  
Keyword(s):  
Contrast Enhancement ◽  
Vessel Wall ◽  
Spin Echo ◽  
Demographic Data ◽  
Fast Spin Echo ◽  
Artery Dissection ◽  
Intracranial Artery ◽  
Aneurysmal Dilation ◽  
Intracranial Artery Dissection

Background and Purpose: The mechanisms involved in progression of non-hemorrhagic intracranial artery dissection (IAD) are poorly understood. Contrast enhancement of intracranial saccular aneurysms on magnetic resonance vessel wall imaging (VWI) is thought to predict instability. We investigated the relationship between contrast enhancement of dissecting lesions and progression of IADs based on the hypothesis that this finding might predict instability. Methods: A total of 39 IADs in 36 patients (17 women and 19 men; mean age: 49 years) were investigated retrospectively. Three-dimensional T1-weighted fast spin-echo sequences were obtained before and after injection of contrast medium, and the vessel wall/pituitary stalk contrast enhancement ratio (CRstalk) was calculated. Progression of IADs was defined as morphological deterioration; progressive dilatation or stenosis. The relations between IAD progression and potential risk factors, including patient demographic data, IAD morphology, and VWI findings, were investigated by statistical analysis. Results: The mean follow-up period was 9.7 months (range: 1-24 months). Progression was detected in 6 of 39 IADs (15%). Five IADs demonstrated aneurysmal dilatation and the other showed stenosis/occlusion. There were no significant differences of demographic factors between the patients with or without IADs progression. IADs with aneurysmal dilation demonstrated significant morphological deterioration (p=0.01). All IADs without contrast enhancement (n=7) improved within one month. Contrast enhancement corresponded to the pseudo-lumen of dissecting lesions. The CRstalk value was significantly higher in IADs with progression than in stable lesions (1.10 ± 0.09 vs. 0.80 ± 0.05, p =0.01). Conclusions: The pseudo-lumen of dissecting lesions may be identified by contrast enhancement. Quantitative analysis of contrast enhancement could be useful for predicting instability of IADs during follow-up.

Magnetic resonance vessel wall imaging predicts morphological deterioration in unruptured intracranial artery dissection

2020 ◽  
Vol 29 (9) ◽  
pp. 105006
Author(s):  
Yukishige Hashimoto ◽  
Toshinori Matsushige ◽  
Koji Shimonaga ◽  
Hiroki Takahashi ◽  
Tatsuya Mizoue ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Vessel Wall ◽  
Vessel Wall Imaging ◽  
Artery Dissection ◽  
Intracranial Artery ◽  
Intracranial Artery Dissection ◽  
Wall Imaging

Republished: Subarachnoid hemorrhage then thrombosis of posterior inferior cerebellar artery dissection: is early surgical exploration warranted?

2015 ◽  
Vol 8 (6) ◽  
pp. e22-e22
Author(s):  
Nikita G Alexiades ◽  
Jason A Ellis ◽  
Philip M Meyers ◽  
E Sander Connolly
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Posterior Inferior Cerebellar Artery ◽  
Definitive Treatment ◽  
Artery Dissection ◽  
Acute Thrombosis ◽  
Cerebellar Artery ◽  
History Of ◽  
Diseased Vessel ◽  
Vessel Thrombosis

The natural history of spontaneous cerebral artery dissection and thrombosis remains uncertain. Concurrent subarachnoid hemorrhage further complicates the therapeutic approach. Thus the best strategy for managing patients with acute vessel thrombosis in the setting of subarachnoid hemorrhage is unclear. Here we present a case of spontaneous posterior inferior cerebellar artery dissection presenting with subarachnoid hemorrhage and acute thrombosis. Although the patient was initially managed conservatively, angiographic follow-up demonstrated recanalization of the diseased vessel, necessitating definitive treatment. Thus we propose that angiographic follow-up is necessary in the management of patients with subarachnoid hemorrhage in association with apparent vessel thrombosis.

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