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Extracranial and Intracranial Vertebrobasilar Dissections:Diagnosis and Prognosis
JNNP 63:46-51, deBray,J.M.,et al, 1997
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Article Abstract
The two most important symptoms of both dissections(81%of patients)were unbearable pain preceding stroke and progressive onset of stroke within a few hours.Severe ultrasonic abnormalities were present in 94%of the patients whereas specific ultrasonic signs(segmental dilation with eccentric channel)were rare in both groups.Major strokes and brainstem strokes represented respectively 67%and 78%in intracranial versus 43%and 29%in extracranial dissections.Severe sequelae(permanent disabling motor or cerebellar deficit)were more often associated with intracranial(44%) than with extracranial dissections(14%).No recurrence of dissection and no cerebral hemorrhage were found under heparin.Significant factors of poor outcome were the initial severity of the stroke and the bilateral location of dissections.The combination of a pain and a progressive onset of the stroke,corroborated by ultrasonic findings,could have helped to recognize most of these types of dissections.Intracranial dissections have a poorer prognosis than extracranial dissections.
 
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angiography,cerebral
angiography,posterior fossa
angiography,vertebral artery
arterial dissection
arterial dissection,basilar
arterial dissection,bilateral
arterial dissection,intracranial
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arterial dissection,vertebral
brainstem,infarction of
cerebrovascular accident
doppler
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neck pain
neurologic disease,diagnoses of
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