title: Intracranial vertebral artery dissection in Wallenberg syndrome.
abstract: OBJECTIVE
  To assess the prevalence of vertebral artery dissection in Wallenberg syndrome.
  
  
  METHODS
  Sixteen patients (12 men, 4 women; mean age at ictus, 51.6 years) with symptoms of Wallenberg syndrome and an infarction demonstrated in the lateral medulla on MR were reviewed retrospectively. The study items were as follows: (a) headache as clinical signs, in particular, occipitalgia and/or posterior neck pain at ictus; (b) MR findings, such as intramural hematoma on T1-weighted images, intimal flap on T2-weighted images, and double lumen on three-dimensional spoiled gradient-recalled acquisition in a steady state with gadopentetate dimeglumine; (c) direct angiographic findings of dissection, such as double lumen, intimal flap, and resolution of stenosis on follow-up angiography; and (d) indirect angiographic findings of dissection (such as string sign, pearl and string sign, tapered narrowing, etc). Patients were classified as definite dissection if they had reliable MR findings (ie, intramural hematoma, intimal flap, and enhancement of wall and septum) and/or direct angiographic findings; as probable dissection if they showed both headache and suspected findings (ie, double lumen on 3-D spoiled gradient-recalled acquisition in a steady state or indirect angiographic findings); and as suspected dissection in those with only headache or suspected findings.
  
  
  RESULTS
  Seven of 16 patients were classified as definite dissection, 3 as probable dissection, and 3 as suspected dissection. Four patients were considered to have bilateral vertebral artery dissection on the basis of MR findings.
  
  
  CONCLUSIONS
  Vertebral artery dissection is an important cause of Wallenberg syndrome.
authors.affiliation: Department of Radiology, Yamagata University School of Medicine, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Hosoya
authors.forename: N
authors.initials: N
authors.lastname: Watanabe
authors.forename: K
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: H
authors.initials: H
authors.lastname: Kubota
authors.forename: Y
authors.initials: Y
authors.lastname: Onodera
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000150:complications*; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000150:complications; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications*; D014854:Lateral Medullary Syndrome / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014711:Vertebral Artery