Dissection of internal carotid and vertebral arteries: clinical presentation, diagnosis, and treatment
The paper gives the data available in the literature and the author’s results of an examination of almost 140 patients with dissection of the internal carotid and vertebral arteries (ICA and VA). Dissection is blood penetration through an intimal tear from the lumen of an artery into its wall to dev...
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| Format: | Article |
| Language: | Russian |
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IMA-PRESS LLC
2013-11-01
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| Series: | Неврология, нейропсихиатрия, психосоматика |
| Subjects: | |
| Online Access: | https://nnp.ima-press.net/nnp/article/view/208 |
| Summary: | The paper gives the data available in the literature and the author’s results of an examination of almost 140 patients with dissection of the internal carotid and vertebral arteries (ICA and VA). Dissection is blood penetration through an intimal tear from the lumen of an artery into its wall to develop intramural hematoma (IMH). The cause of dissection is the weakness of the arterial wall presumably due to mitochondrial cytopathy. IMH narrows/occludes the arterial lumen or is a source of arterioarterial embolism, which in turn leads to ischemic stroke. Stroke as a result of dissection generally develops in young patients, who are not prone to traditional vascular risk factors, frequently after the influence of provocative factors (mild head/neck injury, head jerks, physical strain, contraceptives, etc.). The characteristics of stroke are head/neck pain on the side of dissection that appears a few days prior to stroke or simultaneously with the latter; quite often a good recovery of impaired functions; and low recurrence rates. Another major manifestation, isolated cervicocephalic pain, is encountered in PA dissection more frequently (in almost a third of cases) and in ICA dissection less frequently (about 5%). Magnetic resonance (MR) angiography and fat-saturated T1-weighted MR imaging play a leading role in the verification of dissection. Dissection should be treated with anticoagulants/antiaggregants in its acute phase, as well as with trophic drugs, primarily actovegin, in both acute and chronic phases. |
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| ISSN: | 2074-2711 2310-1342 |