The distributions of cervical and intracranial artery dissections were different between ICAD and VAD. 1.79%, p = 0.029) were more frequently observed in ICAD than in VAD, and dissecting aneurysms were less frequent (13.10% vs. In contrast, dissections of VAD were more common in the intracranial artery (55.36% vs. Dissections of ICAD were more frequently at the extracranial portions of the artery compared with those of VAD (70.24% vs. The frequency of hypertension, diabetes, smoking, drinking, and cervical trauma did not differ between ICAD and VAD. Patients with ICAD were more likely to be men compared with VAD (85.71% vs. The mean age of patients in the ICAD and VAD groups was 43.37 ± 14.01 and 41.00 ± 12.98 years old, respectively. ResultsĪ total of 140 patients with cervicocerebral artery dissection were included in the study, including 84 patients in the ICAD group and 56 in the VAD group. Baseline characteristics, predisposing factors, and radiological features of ICAD versus VAD were compared. MethodsĪll cases diagnosed with cervicocerebral artery dissection, ICAD, or VAD were identified through a medical records database, between January 2010 and January 2020. We conducted a study to investigate the predisposing factors and radiological features in patients with ICAD or VAD. However, very few studies have compared the differential features between internal carotid artery dissection (ICAD) and vertebral artery dissection (VAD), including both cervical and intracranial artery dissections. (J Vasc Surg 1996 24:597-607.Cervicocerebral artery dissection is an important cause of ischemic stroke in young and middle-aged individuals. Patients should undergo a follow-up Duplex scan to identify contralateral ICAD. Duplex scans are accurate for defining carotid abnormalities consistent with ICAD and for indicating the need for arteriography. If diagnosed early, treatment with anticoagulation may prevent stroke. During follow-up, 19 arteries were studied with Duplex scan, and seven had no residual evidence of ICAD.Ĭonclusions: Patients who have ICAD often have prodromal symptoms before stroke. Two patients developed contralateral ICAD. The mean duration of follow-up was 9.3 years. Six patients subsequently had an operation for residual occlusive disease or aneurysm. None of the 21 patients had a subsequent stroke. Of the 21 who survived, 12 were treated with anticoagulation therapy, six with aspirin, and three with aspirin and anticoagulation therapy. Three patients died from stroke during the initial hospitalization.
Duplex scan identified 18 arterial abnormalities consistent with ICAD (sensitivity, 95%).
Seventeen patients who had 19 ICAD underwent a Duplex scan at the time of presentation. Five of the 19 who had visual symptoms or TIA had a stroke before the diagnosis of ICAD.
Results: Nine patients had visual symptoms or headache, 10 had transient focal neurologic symptoms (TIA), and five had stroke. Presenting symptoms, diagnostic tests, clinical management, and outcome were examined. All diagnoses were confirmed by arteriography. Methods: The records from 1976 to 1995 of 24 patients who had 28 ICAD were reviewed. Purpose: This article reviews our experience with internal carotid artery dissection (ICAD), evaluates the usefulness of Duplex scanning in diagnosis, provides current recommendations for treatment, and better defines long-term prognosis.