Dissections of the cervicocerebral arteries.
We present four cases of cerebral ischemia secondary to dissections of cervicocerebal arteries. The majority of patients presented with transient ischemic attacks and strokes, although one patient presented with headache and focal seizure. In addition to history and physical examination, the diagnostic evaluation of these patients included computed tomography scan, carotid duplex studies, angiogram, and, in some cases, magnetic resonance imaging studies. Initially, the patients were anticoagulated with heparin and then with warfarin for a period of six to eight weeks. The emergency physician must consider such dissections in younger patients with sudden neurologic deficits and no or few risk factors for cerebrovascular disease. In our experience, these are not rare syndromes; with proper workup, prompt diagnosis, and therapy, the prognosis is usually excellent.
Power
T
T
Division of Internal Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212.
Hanlon
D
D
Brillman
J
J
D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D000792:Angiography; D000925:Anticoagulants / Q000627:therapeutic use; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011379:Prognosis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery
D000925:Anticoagulants