Imaging in the diagnosis and follow-up evaluation of vertebral artery dissection.
The purpose of this report is to discuss the value of ultrasonographic examination in the diagnosis and follow-up evaluation of vertebral artery dissection. We collected data on 8 patients with 11 pathologic vessels: 9 were affected intracranially and 6 were affected extracranially. Four vessels were affected in both intracranial and extracranial segments. Extracranial color-flow duplex sonography could detect abnormalities in every extracranial vertebral artery dissection. Most abnormal findings were non-specific, including severely reduced flow, absence of flow, and absence of diastolic flow. A specific finding (intramural hematoma) was noted in one artery. Abnormal transcranial color-coded sonographic findings included absence of flow, reduced velocity and reversed flow direction. Three intracranial dissecting arteries showed normal findings on transcranial color-coded sonography. Ultrasonographic follow-up study revealed evidence of improvement; this was noted almost exclusively in the extracranial segments of the vertebral artery but infrequently in the intracranial segment. Extracranial color-flow duplex sonography is sensitive in the detection of extracranial vertebral artery dissection, both in initial diagnosis and in follow-up evaluation.
Lu
C J
CJ
Department of Neurology, National Taiwan University Hospital, Taipei, Republic of China.
Sun
Y
Y
Jeng
J S
JS
Huang
K M
KM
Hwang
B S
BS
Lin
W H
WH
Chen
R C
RC
Yip
P K
PK
D000328:Adult; D000784:Aortic Dissection / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D014463:Ultrasonography; D014711:Vertebral Artery / Q000000981:diagnostic imaging*