Duplex scan findings in patients with spontaneous cervical artery dissections.
OBJECTIVE
to report duplex scan findings in patients with spontaneous internal carotid artery (ICA) or vertebral artery (VA) dissection.


METHODS
the records of 24 patients (13 males and 11 females, median age 48 years [range 25-68 years]) with spontaneous extracranial ICA dissection (n=20) or VA dissection (n=4), identified between January 1995 and December 1999, were retrospectively analysed.


RESULTS
four different abnormal flow patterns were observed in patients with ICA dissection: (a) absence of flow (15%), (b) staccato flow (50%), (c) reduced flow velocity (25%) and, (d) stenotic flow (10%). B-mode ultrasound showed a homogenous echolucent lesion in eight patients and a double lumen in two. Staccato flow along the entire ICA was observed in only four patients without verified dissection during the study period. In the four patients with VA dissection, duplex scanning demonstrated staccato flow in three and reversed low-amplitude pulsatile flow in one.


CONCLUSIONS
duplex scanning is an important noninvasive diagnostic modality in patients with cervical artery dissection. Staccato flow along the extracranial ICA strongly indicates the presence of spontaneous ICA dissection.
Logason
K
K
Department of Surgery, University Hospital, Uppsala, Sweden.
Hårdemark
H-G
HG
Bärlin
T
T
Bergqvist
D
D
Ahlstöm
H
H
Karacagil
S
S
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging*; D001783:Blood Flow Velocity; D020215:Carotid Artery, Internal, Dissection / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018616:Ultrasonography, Doppler, Duplex; D014711:Vertebral Artery / Q000000981:diagnostic imaging*