Related Experiment Video
Updated: Oct 3, 2025
Creation of Two Saccular Elastase-Digested Aneurysms with Different Hemodynamics in One Rabbit
Published on: April 15, 2021
Long-Term Sonographical Follow-Up of Arterial Stenosis Due to Spontaneous Cervical Artery Dissection
Daniel Strunk1, Wolfram Schwindt2, Heinz Wiendl1
1Department of Neurology With Institute of Translational Neurology, University Hospital Münster, Münster, Germany.
Insights
Spontaneous cervical artery dissection (sCAD) shows dynamic changes, with stenosis improving in half of patients. Recurrent sCAD is rare, but careful monitoring is advised.
Area of Science:
- Neurology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Spontaneous cervical artery dissection (sCAD) is a leading cause of stroke in young adults.
- The long-term arterial changes and outcomes following sCAD are not well understood.
Purpose of the Study:
- To analyze the long-term course of arterial stenosis after sCAD.
- To identify factors associated with arterial changes and recurrent sCAD.
Main Methods:
- Adult patients diagnosed with sCAD between 2004 and 2018 were included.
- Repetitive neurovascular ultrasound was performed for follow-up (mean 15.3 months).
- Clinical and imaging data were collected and analyzed.
Main Results:
- Of 259 sCADs in 224 patients, internal carotid and vertebral arteries were most affected.
- Vascular stenosis decreased in 55.7% of arteries, and 54% of occluded arteries recanalized.
- 53.1% of hemodynamically relevant stenoses improved; recurrent sCAD occurred in 5.4% of patients.
Conclusions:
- The sonographical course of sCAD is dynamic, particularly within the first year.
- Half of patients experience decreasing stenosis or recanalization.
- Recurrent sCAD is infrequent in this cohort, necessitating careful monitoring.
Purpose:
Little is known about the long-term course of arterial stenosis after spontaneous cervical artery dissection (sCAD). We analyzed changes over time and evaluated factors potentially associated with these changes and recurring sCAD.
Materials And Methods:
Adult patients with sCAD, admitted to our neurological department between 2004 and 2018, were included. All patients underwent initial and follow-up repetitive neurovascular ultrasound for a mean duration of 15.3 ± 21 months. Clinical and imaging data were registered for each patient.
Results:
A total of 259 sCADs were diagnosed in 224 patients. Either internal carotid arteries (n = 133, 59.4%), vertebral arteries (n = 58, 25.9%), or multiple arteries (n = 33, 14.7%) were affected. In 93 out of 183 patients (51%), and in 117 out of 210 arteries under investigation (55.7%), vascular stenosis decreased over time. Occluded arteries recanalized early in 34 (54%) and stayed occluded in 29 patients (46.0%). Of 145 initially hemodynamically relevant stenosis, 77 (53.1%) improved over time. Overall, 12 patients (5.4 %) had a recurring sCAD during follow-up. Pseudoaneurysms were found in 19 patients.
Conclusion:
The sonographical course of sCAD is highly dynamic within the first year after disease onset and should be monitored carefully. Decreasing degrees of stenosis and recanalization of occluded arteries occurred in half of all patients. Recurrent sCAD was a rare event in our cohort.
More Related Videos
09:36A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
Published on: August 12, 2025
10:41Analysis of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage with High Frequency Transcranial Duplex Ultrasound
Published on: June 3, 2021
Related Concept Videos
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:26Aneurysm III: Interprofessional Care