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Vertebral artery dissection: a treatable cause of ischaemic stroke
Insights
Vertebral artery dissection is increasingly diagnosed using magnetic resonance imaging. Early diagnosis and heparin treatment, when appropriate, can prevent further embolic events in posterior circulation cerebrovascular accidents.
Area of Science:
- Neurology
- Vascular Imaging
Background:
- Vertebral artery dissection (VAD) was historically uncommon but is now more frequently diagnosed.
- Advances in magnetic resonance imaging (MRI) have improved detection rates.
Purpose of the Study:
- To highlight the importance of diagnosing VAD in patients with posterior circulation cerebrovascular accidents (CVAs).
- To illustrate the diagnostic utility of MRI in VAD.
Main Methods:
- Case report of three patients with VAD.
- Utilized magnetic resonance imaging for diagnosis.
Main Results:
- MRI facilitated the diagnosis of VAD in the reported cases.
- VAD was identified as a cause of posterior territory CVAs.
Conclusions:
- Establishing a diagnosis of VAD using MRI is crucial for patients presenting with posterior CVAs.
- Heparin therapy is recommended to prevent recurrent embolic events in VAD, provided no contraindications like subarachnoid hemorrhage exist.
Abstract:
Vertebral artery dissection used to be an uncommon diagnosis but it is now being diagnosed more frequently owing to the use of magnetic resonance imaging. We report on three patients with vertebral artery dissection to illustrate the importance of establishing this diagnosis by using magnetic resonance imaging in patients who present with cerebrovascular accident that involves the posterior territory. Treatment with heparin can help prevent recurrent embolic events and should be given in the absence of subarachnoid haemorrhage or other contra-indications.