title: Carotid and Vertebral Dissection Imaging.
abstract: Carotid or vertebral artery dissection is the result of a tear in the vessel lining wherein the intima separates the media. This creates a false or pseudo lumen, often accompanied by hemorrhage into the arterial wall. Dissection of these craniocervical vessels often manifests with pain alone but, if untreated, may result in severe neurologic compromise. The causes of dissection are multifactorial, including spontaneous, iatrogenic, and traumatic insults. Regardless of etiology, treatment consists primarily of anticoagulation, whereas endovascular therapy is reserved for cases with persistent thrombus or flow limitation. Given the high risk of neurological compromise or death and the propensity of these injuries to occur in younger individuals, early diagnosis of carotid and vertebral artery dissections is critical. Although angiography remains the criterion standard for diagnosis, advances in noninvasive imaging have placed magnetic resonance and computed tomography at the forefront of diagnosis. This article examines the current imaging modalities used to diagnose this under-recognized entity.
authors.affiliation: Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.|Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA.|University at Buffalo Neurosurgery, 100 High Street, Suite B4, Buffalo, NY, 14203, USA.
authors.forename: Hakeem J
authors.initials: HJ
authors.lastname: Shakir
authors.affiliation: Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.|Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA.|University at Buffalo Neurosurgery, 100 High Street, Suite B4, Buffalo, NY, 14203, USA.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Davies
authors.affiliation: Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.|Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA.|University at Buffalo Neurosurgery, 100 High Street, Suite B4, Buffalo, NY, 14203, USA.
authors.forename: Hussain
authors.initials: H
authors.lastname: Shallwani
authors.affiliation: Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.|Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA.|Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.|Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, Buffalo, NY, USA.|Jacobs Institute, Buffalo, NY, USA.|University at Buffalo Neurosurgery, 100 High Street, Suite B4, Buffalo, NY, 14203, USA.
authors.forename: Adnan H
authors.initials: AH
authors.lastname: Siddiqui
authors.affiliation: Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA. elevy@ubns.com.|Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA. elevy@ubns.com.|Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA. elevy@ubns.com.|University at Buffalo Neurosurgery, 100 High Street, Suite B4, Buffalo, NY, 14203, USA. elevy@ubns.com.
authors.forename: Elad I
authors.initials: EI
authors.lastname: Levy
mesh_terms: D020215:Carotid Artery, Internal, Dissection / Q000000981:diagnostic imaging*; D006801:Humans; D059906:Neuroimaging / Q000379:methods*; D020217:Vertebral Artery Dissection / Q000000981:diagnostic imaging*
keywords: Carotid artery; Computed tomographic angiography; Craniocervical dissection; Digital subtraction angiography; Magnetic resonance angiography; Magnetic resonance imaging; Vertebral artery