HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Imaging of Spontaneous and Traumatic Cervical Artery Dissection : Comparison of Typical CT Angiographic Features.

AbstractINTRODUCTION:
Cervical artery dissection (CAD) is an important etiology of ischemic stroke and early recognition is vital to protect patients from the major complication of cerebral embolization by administration of anticoagulants. The etiology of arterial dissections differ and can be either spontaneous or traumatic. Even though the historical gold standard is still catheter angiography, recent studies suggest a good performance of computed tomography angiography (CTA) for detection of CAD. We conducted this research to evaluate the variety and frequency of possible imaging signs of spontaneous and traumatic CAD and to guide neuroradiologists' decision making.
METHODS:
Retrospective review of the database of our multiple injured patients admitted to the Department of Trauma, Hand, and Reconstructive Surgery of the University Hospital Münster in Germany (a level 1 trauma center) for patients with traumatic CAD (tCAD) and of our stroke database (2008-2015) for patients with spontaneous CAD (sCAD) and CT/CTA on initial clinical work-up. All images were evaluated concerning specific and sensitive radiological features for dissection by two experienced neuroradiologists. Imaging features were compared between the two etiologies.
RESULTS:
This study included 145 patients (99 male, 46 female; 45 ± 18.8 years of age), consisting of 126 dissected arteries with a traumatic and 43 with spontaneous etiology. Intimal flaps were more frequently observed after traumatic etiology (58.1% tCADs, 6.9% sCADs; p < 0.001); additionally, multivessel dissections were much more frequent in trauma patients (3 sCADs, 21 tCADs) and only less than half (42%) of the patients with traumatic dissections showed cervical spine fractures.
CONCLUSION:
Neuroradiologists should be aware that intimal flaps and multivessel dissections are more common after a traumatic etiology. In addition, it seems important to conduct a CTA in a trauma setting, even if no cervical spine fracture is detected.
AuthorsPeter B Sporns, Thomas Niederstadt, Walter Heindel, Michael J Raschke, René Hartensuer, Ralf Dittrich, Uta Hanning
JournalClinical neuroradiology (Clin Neuroradiol) Vol. 29 Issue 2 Pg. 269-275 (Jun 2019) ISSN: 1869-1447 [Electronic] Germany
PMID29374294 (Publication Type: Comparative Study, Journal Article)
Topics
  • Carotid Artery, Internal, Dissection (diagnostic imaging)
  • Cervical Vertebrae (blood supply, diagnostic imaging, injuries)
  • Computed Tomography Angiography (methods)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multidetector Computed Tomography (methods)
  • Retrospective Studies
  • Spinal Fractures (complications, diagnostic imaging)
  • Vertebral Artery Dissection (diagnostic imaging)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: