Neurosonographical follow-up in patients with spontaneous cervical artery dissection.
OBJECTIVE
Neurovascular ultrasound (nUS) is widely used as a screening and monitoring tool in patients with spontaneous cervical artery dissection (sCAD). The aim of the study was to describe the sonographical course of the affected arteries in patients with a MRI-proven sCAD by repetitive nUS.


METHODS
Thirty-seven consecutive patients aged<60 years with 1.5 T MRI-proven sCAD were prospectively investigated by nUS, and within 48 hours after admission before MRI. The patients were re-investigated after 6 months and again after a period>12 months.


RESULTS
Forty-nine sCAD were detected in 37 patients; 24 lesions (49%) were located in the internal carotid arteries (ICA), and 25 (51%) in the vertebral arteries (VA). An arterial occlusion was found in 13 arteries (27%). The recanalization rate of occluded arteries was 62%. Regression of stenosis/occlusion within the first 6 months was found in 34 (69%) of the affected arteries, while between 6 and >12 months, the improvement rate was lower (19%). A complete recanalization without residual stenosis after 6 months was found in 39%. In only one artery, initial high grade ICA stenosis progressed to complete persistent occlusion (2%).


CONCLUSIONS
The course of arterial stenosis or occlusion caused by sCAD is highly dynamic during the first 6 month after the event. The vast majority of arteries show regression of stenosis or recanalization of initial occlusion. Only a minority of patients experience a persistent deterioration of the vessel status.
Sengelhoff
Christian
C
Department of Neurology, University of Muenster, Muenster, Germany.
Nebelsieck
Jonas
J
Nassenstein
Isabelle
I
Maintz
David
D
Nabavi
Darius G
DG
Kuhlenbaeumer
Gregor
G
Ringelstein
Erich B
EB
Dittrich
Ralf
R
D000925:Anticoagulants / Q000627:therapeutic use; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D020215:Carotid Artery, Internal, Dissection / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D020767:Intracranial Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods* / Q000706:statistics & numerical data; D014711:Vertebral Artery / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D020217:Vertebral Artery Dissection / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology
D000925:Anticoagulants