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HITS in internal carotid dissections
V Oliveira1, P Batista, F Soares
1Stroke Unit and Cerebral Hemodynamics Laboratory, Department of Neurology, Hospital de Santa Maria, Lisbon, Portugal.
Insights
High-intensity transient signals (HITS) in carotid dissection patients were not associated with clinical outcomes. These microemboli signals were only detected in recent dissections, suggesting limited clinical significance for this specific patient group.
Area of Science:
- Neurology
- Vascular Surgery
Background:
- Carotid artery dissection can lead to neurological deficits via hemodynamic or embolic pathways.
- Anticoagulation therapy is standard for preventing stroke and neurological worsening.
- High-intensity transient signals (HITS) on transcranial Doppler may indicate microembolism.
Purpose of the Study:
- To investigate the presence and number of HITS in patients with carotid dissection.
- To determine the clinical significance of HITS in this patient cohort.
Main Methods:
- A series of 27 patients diagnosed with carotid dissection were evaluated.
- Transcranial Doppler ultrasound was used to detect High-intensity transient signals (HITS).
- Data on clinical presentation, imaging, and treatment were collected and analyzed.
Main Results:
- HITS were detected in 14 (52%) of the patients studied.
- HITS were exclusively observed in dissections with symptom onset less than 7 days prior.
- No significant association was found between HITS and clinical features, imaging findings, neurological progression, or treatment strategy.
Conclusions:
- The study did not find a relevant clinical significance of HITS in patients with carotid dissection.
- The presence of HITS appears limited to the acute phase of carotid dissection (less than 7 days).
- Further research may be needed to fully elucidate the role of microembolism in carotid dissection.
Abstract:
Carotid dissections can cause neurological deficits either by hemodynamic or embolic mechanisms. Anticoagulants are often used in this setting to prevent neurological deterioration and stroke recurrence. High-intensity transient signals (HITS) detected by transcranial Doppler may be due to microembolism. We investigated the presence and number of HITS in a series of 27 patients with carotid dissection. HITS were detected in 14 (52%) patients and only in cases with a less than 7-day evolution. No association was found between HITS and clinical or imagiological features of the dissection nor with neurological aggravation or treatment type. We failed to demonstrate any relevant clinical significance of HITS in carotid dissection.