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Imaging in the diagnosis and follow-up evaluation of vertebral artery dissection

C J Lu1, Y Sun, J S Jeng

  • 1Department of Neurology, National Taiwan University Hospital, Taipei, Republic of China.

Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine
|April 12, 2000
PubMed

Insights

Ultrasonography effectively detects extracranial vertebral artery dissection, aiding diagnosis and follow-up. While it identifies abnormalities in most extracranial cases, intracranial segment improvement is less frequently observed.

Area of Science:

  • Neurology
  • Vascular Imaging
  • Diagnostic Ultrasound

Background:

  • Vertebral artery dissection (VAD) is a significant cause of stroke.
  • Accurate diagnosis and monitoring are crucial for managing VAD.
  • Ultrasonography offers a non-invasive approach to assess the vertebral arteries.

Observation:

  • This study evaluated 8 patients with 11 affected vertebral arteries.
  • Both extracranial and intracranial segments were assessed using color-flow duplex and transcranial color-coded sonography.
  • Data focused on the diagnostic and follow-up capabilities of ultrasonography in VAD.

Findings:

  • Extracranial color-flow duplex sonography detected abnormalities in all extracranial VAD cases.
  • Common extracranial findings included reduced or absent flow and intramural hematoma.
  • Transcranial sonography revealed absent flow, reduced velocity, or reversed flow in intracranial VAD, though three cases were normal.
  • Ultrasonographic follow-up showed improvement primarily in extracranial segments.

Implications:

  • Extracranial color-flow duplex sonography is a sensitive tool for diagnosing and monitoring extracranial VAD.
  • Ultrasonography plays a valuable role in the comprehensive evaluation of vertebral artery dissection.
  • Further research may explore optimizing transcranial sonography for intracranial VAD assessment.

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