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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Main Author: Lyudmila Andreevna Kalashnikova
Format: Article
Language:Russian
Published: IMA-PRESS LLC 2013-11-01
Series:Неврология, нейропсихиатрия, психосоматика
Subjects:
Online Access:https://nnp.ima-press.net/nnp/article/view/208
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author Lyudmila Andreevna Kalashnikova
author_facet Lyudmila Andreevna Kalashnikova
author_sort Lyudmila Andreevna Kalashnikova
collection DOAJ
description 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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spelling doaj.art-0619deaad1394da5ae5c8cfe95c0b88d2024-10-17T16:15:21ZrusIMA-PRESS LLCНеврология, нейропсихиатрия, психосоматика2074-27112310-13422013-11-0152S404510.14412/2074-2711-2013-2357208Dissection of internal carotid and vertebral arteries: clinical presentation, diagnosis, and treatmentLyudmila Andreevna Kalashnikova0Neurology Research Center, Russian Academy of Medical Sciences, MoscowThe 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.https://nnp.ima-press.net/nnp/article/view/208young-onset ischemic strokedissectioninternal carotid arteryvertebral arterymitochondrial arteriopathytreatmentactovegin
spellingShingle Lyudmila Andreevna Kalashnikova
Dissection of internal carotid and vertebral arteries: clinical presentation, diagnosis, and treatment
Неврология, нейропсихиатрия, психосоматика
young-onset ischemic stroke
dissection
internal carotid artery
vertebral artery
mitochondrial arteriopathy
treatment
actovegin
title Dissection of internal carotid and vertebral arteries: clinical presentation, diagnosis, and treatment
title_full Dissection of internal carotid and vertebral arteries: clinical presentation, diagnosis, and treatment
title_fullStr Dissection of internal carotid and vertebral arteries: clinical presentation, diagnosis, and treatment
title_full_unstemmed Dissection of internal carotid and vertebral arteries: clinical presentation, diagnosis, and treatment
title_short Dissection of internal carotid and vertebral arteries: clinical presentation, diagnosis, and treatment
title_sort dissection of internal carotid and vertebral arteries clinical presentation diagnosis and treatment
topic young-onset ischemic stroke
dissection
internal carotid artery
vertebral artery
mitochondrial arteriopathy
treatment
actovegin
url https://nnp.ima-press.net/nnp/article/view/208
work_keys_str_mv AT lyudmilaandreevnakalashnikova dissectionofinternalcarotidandvertebralarteriesclinicalpresentationdiagnosisandtreatment