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Intracranial artery dissection.

T Sikkema1, M Uyttenboogaart, O Eshghi

  • 1Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

European Journal of Neurology
|May 15, 2014
PubMed
Summary
This summary is machine-generated.

Intracranial artery dissection (IAD) is a rare cause of stroke, particularly in young adults. Diagnosis relies on imaging, with treatments varying based on presentation, and outcomes often linked to subarachnoid hemorrhage presence.

Keywords:
intracranial artery dissectionischaemiaprognosissubarachnoid haemorrhagetreatment

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Area of Science:

  • Neurology
  • Vascular Neurology
  • Neuroimaging

Background:

  • Intracranial artery dissection (IAD) is an uncommon yet significant cause of stroke and subarachnoid hemorrhage (SAH), frequently affecting young adults.
  • Understanding the distinct pathogenic mechanisms of subintimal and subadventitial IAD is crucial for predicting outcomes.
  • The etiology of IAD is multifactorial, with various associated risk factors contributing to its development.

Purpose of the Study:

  • To provide a comprehensive narrative review of intracranial artery dissection (IAD).
  • To evaluate the pathogenesis, clinical manifestations, diagnostic approaches, therapeutic strategies, and prognostic factors associated with IAD.

Main Methods:

  • This review synthesizes existing literature on IAD.
  • Information was gathered through a narrative review of relevant scientific publications.
  • Diagnostic criteria and treatment guidelines were analyzed based on current clinical practice and research.

Main Results:

  • IAD presents as either subintimal dissection, potentially leading to stenosis, thromboembolism, and ischemic stroke, or subadventitial dissection, which may cause pseudo-aneurysm formation, mass effect, or SAH upon rupture.
  • Multimodal neuroimaging plays a key role in diagnosing IAD, complementing clinical presentations.
  • Treatment strategies are tailored to the clinical scenario, with anticoagulants or antiplatelets for ischemic events and endovascular procedures for SAH.

Conclusions:

  • IAD is a critical consideration in the differential diagnosis of stroke and SAH, especially in younger populations.
  • The type of IAD and its clinical presentation significantly influence patient prognosis, with SAH indicating a poorer outcome.
  • Accurate diagnosis via neuroimaging and timely, appropriate management are essential for improving patient outcomes in IAD.