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The patients ranged in age from 25 to 82 years (mean, 54.8 years). Clinical symptoms due to ischemic cerebellar and/or brain stem lesions were common, but in 3 cases the dissections were discovered incidentally while an unrelated disorder was investigated. Headache, which has been emphasized as the only specific clinical sign of vertebrobasilar artery dissection, was found in 55% of the patients. Intramural hematoma on T1-weighted images has been emphasized as a specific MR finding. Th e positive rate of intramural hematoma was 32%. Double lumen on 3-dimensional (3-D) spoiled gradient-recalled acquisition (SPGR) images after the injection of contrast medium was identified in 87% of the patients. The 3-D SPGR imaging method is consider ed useful for the screening of vertebrobasilar artery dissection. Intracranial vertebrobasilar artery dissection is probably much more frequent than previously considered. Such patients may present no or only minor symptoms. Neuroradiological screening for posterior circulation requires MR examinations, including contrast-enhanced 3-D SPGR. Angiography may be necessary for the definite diagnosis of intracranial vertebrobasilar artery dissection because the sensitivity of the finding of intramural hema toma is not satisfactory. |
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angiography,cerebral
angiography,vertebral artery
arterial dissection
arterial dissection,basilar
arterial dissection,intracranial
arterial dissection,precipitating events
arterial dissection,vertebral
brainstem,infarction of
headache
headache,severe
MRI
MRI,abnormal
MRI,angiography
neck pain
neurologic disease,diagnoses of
neurologic symptoms
posterior inferior cerebellar artery syndrome
precipitating factors
prognosis
review article
risk factors
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