Long-term follow-up of aneurysms developed during extracranial internal carotid artery dissection.
OBJECTIVE
To evaluate the clinical course of aneurysms developed during extracranial internal carotid artery (ICA) dissection.


BACKGROUND
Aneurysms developed during extracranial ICA dissection are detected angiographically in 5 to 40% of cervical artery dissections. The clinical and radiologic course of these aneurysms is not known, and it is not known how they should be treated.


METHODS
Fifty-eight consecutive patients with extracranial ICA dissection were reviewed, and those with radiographically detectable dissecting aneurysm at the acute stage or during early follow-up were included in this study. All patients had regular clinical and MR angiography examinations. Sixteen patients (27.5%) with a total of 20 ICA dissecting aneurysms were followed for a mean period of 36.9+/-21 months (range, 10 to 93 months).


RESULTS
No clinical symptoms suggestive of aneurysmal rupture or embolization from the aneurysm were identified. Extracranial ICA aneurysms remained unchanged in 65% of patients, were resolved in 5% of patients, and decreased in size in 30% of patients.


CONCLUSIONS
The clinical course of dissecting aneurysms was benign, although spontaneous radiologic resolution occurred rarely. Medical management with antiplatelet therapy alone (after early anticoagulation) is generally sufficient, and surgical management was seldom required.
Service de Neurologie, Hôpital Lariboisière, Paris, France.
B
B
Guillon
L
L
Brunereau
V
V
Biousse
H
H
Djouhri
C
C
Lévy
M G
MG
Bousser
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D000925:Anticoagulants / Q000627:therapeutic use; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D013997:Time Factors
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors