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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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