Intracranial artery dissection

T. Sikkema*, Maarten Uyttenboogaart, O. Eshghi, J. De Keyser, R. Brouns, J.M.C. van Dijk, G. J. Luijckx

*Bijbehorende auteur voor dit werk

    OnderzoeksoutputAcademicpeer review

    52 Citaten (Scopus)

    Samenvatting

    The aim of this narrative review is to evaluate the pathogenesis, clinical features, diagnosis, treatment and prognosis of intracranial artery dissection (IAD). IAD is a rare and often unrecognized cause of stroke or subarachnoid haemorrhage (SAH), especially in young adults. Two types of IAD can be identified: a subintimal or subadventitial dissection. It is suggested that a subintimal dissection results in luminal stenosis, thromboembolism and subsequently cerebral ischaemia, whilst a subadventitial IAD could result in the formation of a pseudo-aneurysm and compression on brainstem or cranial nerves. Rupture of such a dissecting aneurysm causes SAH. The exact cause of IAD remains unknown but several factors are associated with its development. Diagnosis is based on clinical presentation and specific features seen on multimodal neuroimaging. The management of IAD depends on the clinical presentation. In the case of cerebral ischaemia, anticoagulants or antiplatelet agents are used, whilst in the case of SAH endovascular treatment is primarily advocated. Prognosis depends on clinical presentation. Presentation with SAH has a worse prognosis.

    Originele taal-2English
    Pagina's (van-tot)820-826
    Aantal pagina's7
    TijdschriftEuropean Journal of Neurology
    Volume21
    Nummer van het tijdschrift6
    DOI's
    StatusPublished - jun-2014

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