Extracranial and intracranial artery dissections: Experiences from a tertiary referral center
Extracranial and intracranial artery dissections: Experiences from a tertiary referral center
Yazar: Deniz, Çiğdem; Asil, Talip; Tunç, Abdulkadir
Dergi: Dicle Tıp Dergisi, Vol. 45 No. 4, 2018
Anahtar kelimeler: Stroke,dissection,etiology

Background:Craniocervical artery dissection is an important cause of ischemic strokeespecially in young and middle aged adults. In this study, we evaluatedextracrainal and intracranial artery dissections in terms of etiologies, riskfactors, stroke severity and functional outcomes. Methods: Atotal of 29 patients who were diagnosed with ischemic stroke due toextracranial or intracranial artery dissections were enrolled to this study.The ischemic stroke diagnosis was confirmed with diffusion weighted magneticresonance imaging in all patients. Computed tomography angiography, magneticresonance angiography and digital subtraction angiography were used todemonstrate the dissection. Demographic findings, risk factors and presence oftrauma were evaluated. National Institute of Health Score Scale (NIHSS) wasused for stroke severity assessment at disease onset. Functional outcomes weremeasured with Modified Rankin Scale (mRS) at the 3rd month. Results:Fifteen patients (51.72%) had carotid artery dissections while 12 patients(41.37%) had vertebral artery dissection (VAD), 1 (3.4%) had basilar arterydissection (BAD) and both VAD and BAD were seen in 1 patient (3.4%).Coagulopathy was detected in 12 patients (41.37%). Connective tissue diseasewas suspected in 3 patients (10.3%). In 6 patients, dissections occured aftertrauma. Nineteen patients (65.51%) presented with somatosensory deficits. The3rd month mRS scores were in the range of 0-2 and no significant correlationwas found in terms of risk factors, etiology and trauma history.Conclusion:Arterial dissection should be kept in mind for the clinical presentation ofischemic stroke in young adults. We think that better understanding of the riskfactors, etiologies and clinical presentation of the dissections and earlydiagnosis-proper treatments might yield improved clinical outcomes.

Background:Craniocervical artery dissection is an important cause of ischemic strokeespecially in young and middle aged adults. In this study, we evaluatedextracrainal and intracranial artery dissections in terms of etiologies, riskfactors, stroke severity and functional outcomes. Methods: Atotal of 29 patients who were diagnosed with ischemic stroke due toextracranial or intracranial artery dissections were enrolled to this study.The ischemic stroke diagnosis was confirmed with diffusion weighted magneticresonance imaging in all patients. Computed tomography angiography, magneticresonance angiography and digital subtraction angiography were used todemonstrate the dissection. Demographic findings, risk factors and presence oftrauma were evaluated. National Institute of Health Score Scale (NIHSS) wasused for stroke severity assessment at disease onset. Functional outcomes weremeasured with Modified Rankin Scale (mRS) at the 3rd month. Results:Fifteen patients (51.72%) had carotid artery dissections while 12 patients(41.37%) had vertebral artery dissection (VAD), 1 (3.4%) had basilar arterydissection (BAD) and both VAD and BAD were seen in 1 patient (3.4%).Coagulopathy was detected in 12 patients (41.37%). Connective tissue diseasewas suspected in 3 patients (10.3%). In 6 patients, dissections occured aftertrauma. Nineteen patients (65.51%) presented with somatosensory deficits. The3rd month mRS scores were in the range of 0-2 and no significant correlationwas found in terms of risk factors, etiology and trauma history.Conclusion:Arterial dissection should be kept in mind for the clinical presentation ofischemic stroke in young adults. We think that better understanding of the riskfactors, etiologies and clinical presentation of the dissections and earlydiagnosis-proper treatments might yield improved clinical outcomes.