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Review
. 2016 Sep 15;56(9):524-33.
doi: 10.2176/nmc.ra.2015-0294. Epub 2016 May 13.

Diagnosis of Intracranial Artery Dissection

Masafumi Kanoto  1 , Takaaki Hosoya
Affiliations
Review

Diagnosis of Intracranial Artery Dissection

Masafumi Kanoto et al. Neurol Med Chir (Tokyo). .

Abstract

Cerebral arterial dissection is defined as a hematoma in the wall of a cervical or an intracranial artery. Cerebral arterial dissection causes arterial stenosis, occlusion, and aneurysm, resulting in acute infarction and hemorrhage. Image analysis by such methods as conventional angiography, computed tomography, magnetic resonance imaging, and so on plays an important role in diagnosing cerebral arterial dissection. In this study, we explore the methods and findings involved in the diagnosis of cerebral arterial dissection.

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Conflict of interest statement

This study was not affected by any conflicts of interest pertaining to the authors or our institute.

Figures

Fig. 1
Fig. 1
53-year-old male. Bilateral vertebral artery dissection. Catheter angiography (3 days from onset) shows right vertebral artery irregularity (A), left vertebral artery proximal dilatation (B, ▼) and distal stenosis (B, →).
Fig. 2
Fig. 2
54-year-old male. Right anterior cerebral artery territory infarction due to anterior cerebral artery dissection. Diffusion weighted image (2 days from onset) reveals anterior cerebral artery territory acute infarction (A). Catheter angiography (16 days) reveals proximal stenosis (→) and distal dilatation (▼), also known as the “pearl and string sign”, in right anterior cerebral artery (B). Three-dimensional multisection motion sensitized driven equilibrium (12 days) shows high intensity crescent (▽).
Fig. 3
Fig. 3
44-year-old male. Wallenberg syndrome due to right vertebral artery dissection. Diffusion weighted image (0 days from onset) reveals right lateral medullary infarct (A). Catheter angiography (0 days) reveals fusiformic dilatation in right vertebral artery (→) (B).
Fig. 4
Fig. 4
54-year-old female. Right posterior inferior cerebellar artery dissection. Multisection motion sensitized driven equilibrium (1 month from onset) reveals high-intensity intramural hematoma in right posterior inferior cerebellar artery (A, →). Volume rendering image of CT angiography (1 month) reveals right posterior inferior cerebellar artery irregularity in comparison with left posterior inferior cerebellar artery (B, →). Magnetic resonance angiography (1 month) shows no delineation of right posterior inferior cerebellar artery (C, ▽).
Fig. 5
Fig. 5
53-year-old male. Bilateral vertebral artery dissection. Magnetic resonance angiography source images (3 days from onset) reveal double lumen in bilateral vertebral artery (→).
Fig. 6
Fig. 6
37-year-old female. Left vertebral artery to basilar artery dissection. Axial and coronal T 1 -weighted images (3 days from onset) reveal high-intensity intramural hematoma (A, B, ▽). Double lumen in left vertebral artery is revealed by Gd-T 1 TFE (C, ▽).
Fig. 7
Fig. 7
53-year-old female. Right vertebral artery dissection. Magnetic resonance angiography (2 days from onset) shows occlusion of right vertebral artery (A). Basiparallel anatomic scanning reveals outer shape of right vertebral artery is normal (B). These findings indicate vertebral artery occlusion because of arterial dissection.
Fig. 8
Fig. 8
70-year-old female. Left posterior cerebral artery dissection Magnetic resonance angiography (10 days from onset) shows occlusion in left posterior cerebral artery P2 segment (A). Magnetic resonance cisternography shows normal outer shape of proximal left posterior cerebral artery P2 segment (B, →). Thin slice multisection motion sensitized driven equilibrium (0.8 mm) reveals small crescent isointensity intramural hematoma in the proximal left posterior cerebral artery P2 segment (C, →).
Fig. 9
Fig. 9
Recommended diagnostic procedure
See this image and copyright information in PMC

References

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