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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 arterial dissection,multiple arterial dissection,vertebral brainstem,infarction of cerebrovascular accident doppler doppler,color doppler,transcranial duplex ultrasound neck pain neurologic disease,diagnoses of pain prognosis ultrasonography
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