Skip to main content

Imaging Findings in Carotid Artery Dissection

  • Chapter
Imaging of Carotid Artery Stenosis
  • 1147 Accesses

Abstract

Internal carotid artery (ICA) dissections are an increasingly recognized cause of stroke, particularly due to the development of non-invasive imaging techniques in the last few years. Most reported dissections involve the extracranial portion of the ICA, even though dissection of its intracranial portion has been more recognized and described recently.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 269.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Adams C, Trevenen C: Middle cerebral artery dissection. Neuropediatrics 27: 331–332 (1996).

    Article  PubMed  CAS  Google Scholar 

  2. Alom J, Matias-Guiu J, Padro L, Molins M, Romero F, Codina A: Spontaneous dissection of intracranial vertebral artery: clinical recovery with conservative treatment. J Neurol Neurosurg Psychiatry 49: 599–600 (1986).

    PubMed  CAS  Google Scholar 

  3. Anson J, Crowell RM: Cervicocranial arterial dissection. Neurosurgery 29: 89–96 (1991).

    Article  PubMed  CAS  Google Scholar 

  4. Anzalone N, Strada L, Serra L et al.: Value of 3D contrast-enhanced MR: angiography in the diagnosis and follow-up of carotid and vertebral artery dissection. 2002 ASNR Annual Meeting Abstracts.

    Google Scholar 

  5. Arnold M, Nedeltchev K, Sturzenegger M et al.: Thrombolysis in patients with acute stroke caused by cervical artery dissection: analysis of 9 patients and review of the literature. Arch Neurol 59: 549–553 (2002).

    Article  PubMed  Google Scholar 

  6. Ast G, Woimant F, Georges B et al.: Spontaneous dissection of the internal carotid artery in 68 patients. Eur J Med 2: 466–472 (1993).

    PubMed  CAS  Google Scholar 

  7. Auer D, Karnath HO, Nagele T et al.: Noninvasive investigation of pericarotid syndrome: role of MR angiography in the diagnosis of internal carotid dissection [Review]. Headache 35: 163–168 (1995).

    Article  PubMed  CAS  Google Scholar 

  8. Babikian VL, Forteza AM, Gavrilescu T, Samaraweera R: Cerebral microembolism and extracranial internal carotid artery dissection. J Ultrasound Med 15: 863–866 (1996).

    PubMed  CAS  Google Scholar 

  9. Bakke SJ, Smith HJ, Kerty E, Dahl A: Cervicocranial artery dissection. Detection by Doppler ultrasound and MR angiography. Acta Radiol 37: 529–534 (1996).

    Article  PubMed  CAS  Google Scholar 

  10. Barbour PJ, Castaldo JE, Rae-Grant AD: Internal carotid artery redundancy is significantly associated with dissection. Angiographically based study comparing 13 patients with dissection and 108 without. Stroke 25:1201–1206 (1994).

    PubMed  CAS  Google Scholar 

  11. Bassetti C, Carruzzo A, Sturzenegger M et al.: Recurrence of cervical artery dissection. A prospective study of 81 patients. Prospective study of cervical dissection recurrence. Dissections recur in 45 of cases during a mean follow-up period of 34 months. Stroke 27: 1804–1807 (1996).

    PubMed  CAS  Google Scholar 

  12. Beletsky V, Nadareishvili Z, Lynch J et al.: Canadian Stroke Consortium. Cervical arterial dissection: time for a therapeutic trial? Stroke 34: 2856–2860 (2003).

    Article  PubMed  Google Scholar 

  13. Berger MS, Wilson CB: Intracranial dissecting aneurysms of the posterior circulation. J Neurosurg 61:882–894 (1984).

    PubMed  CAS  Google Scholar 

  14. Biggs KL, Chiou AC, Hagino RT et al.: Endovascular repair of a spontaneous carotid artery dissection with carotid stent and coils. J Vasc Surg 40: 170–173 (2004).

    Article  PubMed  Google Scholar 

  15. Biousse V, D’Anglejan-Chatillion J, Touboul PJ et al.: Time course of symptoms in extracranial carotid artery dissections. A series of 80 patients [Review]. Stroke 26:235–239 (1995).

    PubMed  CAS  Google Scholar 

  16. Bogousslavsky J, Despland PA, Regli F: Spontaneous carotid dissection with acute stroke. Arch Neurol 44:137–140 (1987).

    PubMed  CAS  Google Scholar 

  17. Brandt T, Hausser I, Orberk E et al.: Ultrastructural connective tissue abnormalities in patients with spontaneous cervicocerebral artery dissections. Ann Neurol 44: 281–285 (1998).

    Article  PubMed  CAS  Google Scholar 

  18. Campeau NG, Huston J 3rd, Bernstein MA et al.: Magnetic resonance angiographic at 3.0 Tesla: initial clinical experience. Top Magn Reson Imaging 12: 183–204 (2001).

    Article  PubMed  CAS  Google Scholar 

  19. Caplan LR, Biousse V: Cervicocranial arterial dissections. J Neuro-Ophthalmol 24: 299–305 (2004).

    Article  Google Scholar 

  20. Chakeres DW, Abduljalil AM, Novak P et al.: Comparison of 1.5 and 8 Tesla high-resolution magnetic resonance imaging of lacunar infarcts. J Comput Assist Tomogr 26: 628–632 (2002).

    Article  PubMed  Google Scholar 

  21. Chang V, Rewcastle NB, Harwood-Nash DC et al.: Bilateral dissecting aneurysms of the intracranial internal carotid arteries in an 8 year-old boy. Neurology 25:573–579 (1975).

    PubMed  CAS  Google Scholar 

  22. Chaves C, Estol C, Esnaola MM et al.: Spontaneous Intracranial Carotid Artery Dissection — Report of ten patients. Arch Neurol 59: 977–981 (2002).

    Article  PubMed  Google Scholar 

  23. Cohen JE, Tamir B-H, Rajz G et al.: Endovascular Stent-Assisted angioplasty in the management of traumatic internal carotid artery dissections. Stroke 36:e45–e47 (2005).

    Article  PubMed  Google Scholar 

  24. Cohen JE, Leker RR, Gotkine M et al.: Emergent Stenting to treat patients with carotid artery dissection. Stroke 34: e254–e257 (2003).

    Article  PubMed  Google Scholar 

  25. Connett MC, Lansche JM: Fibromuscular hyperplasia of the internal carotid artery: Report of a case. Ann Surg 162: 59–62 (1965).

    Article  PubMed  CAS  Google Scholar 

  26. Culebras A, Kase CS, Masdeu JC et al.: Practice guidelines for the use of imaging in transient ischemic attacks and acute stroke. A report of the Stroke Council, American Heart Association. Stroke 28: 1480–1497 (1997).

    PubMed  CAS  Google Scholar 

  27. Cull RE: Internal carotid artery occlusion caused by giant cell arteritis. J Neurol Neurosurg Psychiatry 42:1066–1067 (1979).

    PubMed  CAS  Google Scholar 

  28. Dal Pozzo G, Mascalchi M, Fonda C et al.: Lower cranial nerve palsy due to dissection of the internal carotid artery: CT and MRI imaging. J Comput Assist Tomogr 13: 989–995 (1989).

    Article  Google Scholar 

  29. Davis SM, Donnan GA: Advances in penumbra imaging with MR. Cerebrovasc Dis 17: 23–27 (2004).

    Article  PubMed  Google Scholar 

  30. Derex L, Nighoghossian N, Turjman F et al.: Intravenous tPA in acute ischemic stroke related to internal carotid artery dissection. Neurology 54: 2159–2161 (2000).

    PubMed  CAS  Google Scholar 

  31. Duyff RF, Snijders CJ, Vanneste JAL: Spontaneous bilateral internal carotid artery dissection and migraine: a potential diagnostic delay. Headache 37: 109–112 (1997).

    Article  PubMed  CAS  Google Scholar 

  32. Ehrenfeld WK, Wylie EJ: Spontaneous dissection of the internal carotid artery. Arch Surg 111: 1294–1301 (1976).

    PubMed  CAS  Google Scholar 

  33. Elijovich L, Kazmi K, Law M: Diagnosis of carotid artery dissection: is multi-slice detector CT Angiography better than MR Angiography? [Abstract]

    Google Scholar 

  34. Engelter ST, Lyrer PA, Kirsch EC et al.: Long-term follow-up after extracranial internal carotid artery dissection. Eur Neurol 44: 199–204 (2000).

    Article  PubMed  CAS  Google Scholar 

  35. Fisher CM, Ojemann RG, Roberson GH: Spontaneous dissection of cervicocerebral arteries. Can J Neurol Sci 5: 9–19 (1978).

    PubMed  CAS  Google Scholar 

  36. Gelbert F, Assouline E, Hodes JE et al.: MRI in spontaneous dissection of vertebral and carotid arteries: 15 cases studied at 0.5 Tesla. Neuroradiology 33: 111–113 (1991).

    Article  PubMed  CAS  Google Scholar 

  37. Goldberg HI, Grossman RI, Gomori JM, Asbury AK, Bilanuek LT, Zimmerman RA: Cervical internal carotid artery dissecting hemorrhage: diagnosis using MR. Radiology 158: 157–161 (1986).

    PubMed  CAS  Google Scholar 

  38. Goldstein LB, Gray L, Hulette CM: Stroke due to recurrent ipsilateral carotid artery dissection in a young adult. Case report of an ipsilaterally recurring ICA dissection. Microscopic examination of the resected pseudoaneurysm showed abnormalities consistent with fibromuscular dysplasia, while conventional angiography failed to demonstrate the usual features. Stroke 26: 480–483 (1995).

    PubMed  CAS  Google Scholar 

  39. Grosman H, Fomasier VL, Bonder D et al.: Dissecting aneurysm of the cerebral arteries. J Neurosurg 53: 693–697 (1980).

    PubMed  CAS  Google Scholar 

  40. Guillon B, Levy C, Bousser MG: Internal carotid artery dissection: an update. J Neurol Sci 153: 146–158 (1998).

    Article  PubMed  CAS  Google Scholar 

  41. Hart RG, Easton JD: Dissection of cervical and cerebral arteries. Neurologic Clin 1: 155–182 (1983).

    CAS  Google Scholar 

  42. Hausser I, Muller U, Engelter S et al.: Different types of connective tissue alterations associated with cervical artery dissections. Acta Neuropathol (Berlin) 107: 509–514 (2004).

    Article  PubMed  Google Scholar 

  43. Hayashi N, Fukuda O, Endo S et al.: Intracerebral hemorrhage secondary to dissecting aneurysm of the anterior cerebral artery. No To Shinkei 48: 1053–1056 (1996).

    PubMed  CAS  Google Scholar 

  44. Hegedus K: Dissecting intracranial aneurysm. Arch Psychiatr Nervenkr 232: 25–32 (1982).

    Article  PubMed  CAS  Google Scholar 

  45. Hennerici M, Steinke W, Rautenberg W: High-resistance Doppler flow pattern in extracranial carotid dissection. Arch Neurol 46: 670–672 (1989).

    PubMed  CAS  Google Scholar 

  46. Hessel SJ, Adams DF, Abrams HL: Complications of angiography. Radiology 138: 273–281 (1981).

    PubMed  CAS  Google Scholar 

  47. Hochberg FH, Bean C, Fisher CM et al.: Stroke in a 15 year-old girl secondary to terminal carotid dissection. Neurology 25: 725–729 (1975).

    PubMed  CAS  Google Scholar 

  48. Howard GF 3rd, Ho SU, Kim KS et al.: Bilateral carotid artery occlusion resulting from giant cell arteritis. Ann Neurol 15: 204–207 (1984).

    Article  PubMed  Google Scholar 

  49. Kawaguchi T, Kawano T, Kazekawa K et al.: Dissecting aneurysm of the middle cerebral artery with subarachnoid hemorrhage and brain infarction: a case report. No Shinkei Geka 25: 1033–1037 (1997).

    PubMed  CAS  Google Scholar 

  50. Kidwell CS, Alger JR, Saver JL: Beyond mismatch: evolving paradigms in imaging the ischemic penumbra with multimodal magnetic resonance imaging. Stroke 34: 2729–2735 (2003).

    Article  PubMed  Google Scholar 

  51. Koennecke HC, Trocio SH, Mast H et al.: Microemboli on transcranial Doppler in patients with spontaneous carotid artery dissection. J Neuroimag 7: 217–220 (1997).

    CAS  Google Scholar 

  52. Koyama S, Kotani A, Sasaki J: Spontaneous dissecting aneurysm of the anterior cerebral artery: Report of two cases. Surg Neurol 46: 55–61 (1996).

    Article  PubMed  CAS  Google Scholar 

  53. Leclerc X, Lucas C, Godefroy O et al.: Preliminary experience using contrast-enhanced MR angiography to assess vertebral artery structure for the follow-up of suspected dissection. AJNR 20: 1482–1490 (1999).

    PubMed  CAS  Google Scholar 

  54. Leclerc X, Godefroy O, Salhi A et al.: Helical CT for the diagnosis of extracranial internal carotid artery dissection. Stroke 27: 461–466 (1996).

    PubMed  CAS  Google Scholar 

  55. Levy C, Laissy JP, Raveau V et al.: Carotid and vertebral artery dissections: three-dimensional time-of-flight MR angiography and MR imaging versus conventional angiography. Radiology 190: 97–103 (1994).

    PubMed  CAS  Google Scholar 

  56. Leys D, Moulin T, Stojkovic T et al.: DONALD investigators. Follow-up of patients with history of cervical artery dissection. One of the largest series of cervical dissections with long-term follow-up assessment. Cerebrovasc Dis 5: 43–49 (1995).

    Google Scholar 

  57. Long TD, Carter MP, Reynolds T: Spontaneous internal carotid artery dissection shown by magnetic resonance imaging. South Med J 84: 1140–1142 (1991).

    Article  PubMed  CAS  Google Scholar 

  58. Lyrer P, Engelter S.: Antithrombotic drugs for carotid artery dissection. Cochrane Database Syst Rev 3:CD000255 (2003).

    Google Scholar 

  59. Malek AM, Higashida RT, Phatouros CC et al.: Endovascular management of extracranial carotid artery dissection achieved using stent angioplasty. AJNR 21:1280–1292 (2000).

    PubMed  CAS  Google Scholar 

  60. Manz HJ, Luessenhop AJ: Dissecting aneurysm of intracranial vertebral artery: a case report and review of literature. J Neurol 230: 25–35 (1983).

    Article  PubMed  CAS  Google Scholar 

  61. Manz HJ, Vester J, Lavenstein B: Dissecting aneurysm of cerebral arteries in childhood and adolescence. Virchows Arch [Pathol Anat] 384: 325–335 (1979).

    Article  CAS  Google Scholar 

  62. Massoud TF, Anslow P, Molyneux AJ: Subarachnoid hemorrhage following spontaneous intracranial carotid artery dissection. Neuroradiology 34: 33–35 (1992).

    Article  PubMed  CAS  Google Scholar 

  63. Meuli RA: Imaging viable brain tissue with CT scan during acute stroke. Cerebrovasc Dis 17Suppl 3: 28–34 (2004).

    Article  PubMed  Google Scholar 

  64. Miyahara K, Sakata K, Gondo G et al.: Spontaneous dissection of the anterior cerebral artery presenting subarachnoid hemorrhage and cerebral infarction: a case report. No Shinkei Geka 29: 335–339 (2001).

    PubMed  CAS  Google Scholar 

  65. Mizutani T, Golberg HI, Parr J et al.: Cerebral dissecting aneurysm and intimal fibroelastic thickening of cerebral arteries. J Neurosurg 56: 571–576 (1982).

    PubMed  CAS  Google Scholar 

  66. Mokri B, Houser W, Sandok BA et al.: Spontaneous dissections of the vertebral arteries. Neurology 38: 880–885 (1988).

    PubMed  CAS  Google Scholar 

  67. Mokri B, Sundt TM Jr, Houser OW et al.: Spontaneous dissection of the cervical internal carotid artery. Ann Neurol 19: 126–138 (1986).

    Article  PubMed  CAS  Google Scholar 

  68. Moore P, Richardson B: Neurology of the vasculitides and connective tissue disease. J Neurol Neurosurg Psych 65: 10–22 (1998).

    CAS  Google Scholar 

  69. Nguyen Bui, Brant-Zawadzki M, Verghese P et al.: Magnetic resonance angiography of cervicocranial dissection. Stroke 24: 126–131 (1993).

    Google Scholar 

  70. Nunez DB Jr., Torres-Leon M, Munera F: Vascular injuries of the neck and thoracic inlet: Helical CT-angiographic correlation. RadioGraphics 24: 1087–1100 (2004).

    Article  PubMed  Google Scholar 

  71. Oelerich M, Stogbauer F, Kurlemann G et al.: Craniocervical arterial dissection. MR imaging and MR angiographic findings. Eur Radiol 9: 1385–1391 (1999).

    Article  PubMed  CAS  Google Scholar 

  72. Okamoto T, Miyachi S, Negoro M et al.: Experimental model of dissecting aneurysms. AJNR 23: 577–584.

    Google Scholar 

  73. Ojemann RG, Fisher CM, Rich JC: Spontaneous dissecting aneurysms of the internal carotid artery. Stroke 3: 434–500 (1972).

    PubMed  CAS  Google Scholar 

  74. Ozdoba C, Sturzenegger M, Schroth G: Internal carotid artery dissection: MR imaging features and clinico-radiologic correlation. Radiology 199: 191–198 (1996).

    PubMed  CAS  Google Scholar 

  75. Pessin MS, Adelman LS, Barbas NR: Spontaneous intracranial carotid artery dissection. Stroke 20: 1100–1113 (1989).

    PubMed  CAS  Google Scholar 

  76. Petro GR, Witwer GA, Cacayorin ED et al.: Spontaneous dissection of the cervical internal carotid artery: correlation of arteriography, CT, and pathology. AJR Am Roentgenol 148: 393–398 (1987).

    CAS  Google Scholar 

  77. Rosebraugh CJ, Griebel DJ, DiPette DJ: A case report of carotid artery dissection presenting with a cluster headache. Am J Med 102: 418–419 (1997).

    Article  PubMed  CAS  Google Scholar 

  78. Schievink WI: Spontaneous dissection of the carotid and vertebral arteries. N Engl J Med 344: 898–906 (2001).

    Article  PubMed  CAS  Google Scholar 

  79. Schievink WI: The treatment of spontaneous carotid and vertebral artery dissections. Curr Opin Cardiol 15:316–321 (2000).

    Article  PubMed  CAS  Google Scholar 

  80. Schievink WI, Mokri B, Piepgras DG et al.: Recurrent spontaneous arterial dissections. Risk in familial versus nonfamilial disease. Study of the risk recurrence among 200 patients with cervical dissection. Family history of arterial dissection is the main risk factor. Stroke 27:622–624 (1996).

    PubMed  CAS  Google Scholar 

  81. Schievink WI, Mokri B, O’Fallon WM: Recurrent spontaneous cervical artery dissection. Long-term follow-up study of 200 patients with cervical dissection (163 involving the ICA), with emphasis on the risk of recurrence. N Engl J Med 330: 393–397 (1994).

    Article  PubMed  CAS  Google Scholar 

  82. Schievink WI, Mokri B, Piepgras DG: Spontaneous dissections of cervicocephalic arteries in childhood and adolescence. Neurology 44: 1607–1612 (1994).

    PubMed  CAS  Google Scholar 

  83. Schmitt F, Grosu D, Mohr C et al.: 3 Tesla MRI: successful results with higher field strengths. Radiologe 44(1): 1–47 (2004).

    Article  Google Scholar 

  84. Sinclair W: Dissecting aneurysm of the middle cerebral artery associated with migraine syndrome. Am J Pathol 29: 1083 (1953).

    PubMed  Google Scholar 

  85. Srinivasan J, Newell DW, Sturzenegger M et al.: Transcranial Doppler in the evaluation of internal carotid artery dissection. Stroke 27: 1226–1230 (1996).

    PubMed  CAS  Google Scholar 

  86. Stapf C, Elkind MSV, Mohr JP: Carotid dissection. Annu Rev Med 51: 329–347 (2000).

    Article  PubMed  CAS  Google Scholar 

  87. Steinke W, Rautenberg W, Schwartz A et al.: Non-invasive monitoring of internal carotid artery dissection. Assessment of ultrasound methods in 48 patients in the early stage and at follow-up. Demonstration of its accuracy in the recanalization process. Stroke 25: 998–1005 (1994).

    PubMed  CAS  Google Scholar 

  88. Stringaris K, Liberopoulos K, Giaka E et al.: Three-dimensional time-of-flight MR angiography and MR imaging versus conventional angiography in carotid artery dissections. Int Angiol 15: 20–25 (1996).

    PubMed  CAS  Google Scholar 

  89. Sturzenegger M, Mattle HP, Rivoir A: Baumgartner RW. Ultrasound findings in carotid artery dissection: analysis of 43 patients. Neurology 45: 691–698 (1995).

    PubMed  CAS  Google Scholar 

  90. Sturzenegger M: Spontaneous internal carotid artery dissection: early diagnosis and management in 44 patients. A large series of spontaneous ICA dissection. J Neurol 242: 231–238 (1995).

    Article  PubMed  CAS  Google Scholar 

  91. Thielen KR, Wijdicks EF, Nichols DA: Giant cell (temporal) arteritis: involvement of the vertebral and internal carotid arteries. Mayo Clin Proc 73: 444–446 (1998).

    Article  PubMed  CAS  Google Scholar 

  92. Tzourio C, Benslamia L, Guillon B et al.: Migraine and the risk of cervical artery dissection: a case-control study. Neurology 59: 435–437 (2002).

    PubMed  CAS  Google Scholar 

  93. Verghese J, Kachroo A, Sparr SA: Herpes zoster ophthalmicus mimicking carotid artery dissection: a case report. Headache 37: 663–664 (1997).

    Article  PubMed  CAS  Google Scholar 

  94. Wilkinson IMS, Russell RWR: Arteries of the head and neck in giant cell arteritis. A pathological study to show the pattern of arterial involvement. Arch Neurol 27: 378–391 (1972).

    PubMed  CAS  Google Scholar 

  95. Yonas H, Agamanolis D, Takaoka Y et al.: Dissecting intracranial aneurysms. Surg Neurol 8: 407–415 (1977).

    PubMed  CAS  Google Scholar 

  96. Zetterling M, Carlstrom C, Konrad P: Internal carotid artery dissection. Review article. Acta Neurol Scand 101: 1–7 (2000).

    Article  PubMed  CAS  Google Scholar 

  97. Zuber M, Meary E, Meder JF et al.: Magnetic resonance imaging and dynamic CT scan in cervical arterial dissections. Stroke 25: 576–581 (1994).

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer-Verlag/Wien

About this chapter

Cite this chapter

Chaves, C., Lee, G. (2007). Imaging Findings in Carotid Artery Dissection. In: Schaller, B.J. (eds) Imaging of Carotid Artery Stenosis. Springer, Vienna. https://doi.org/10.1007/978-3-211-32509-4_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-211-32509-4_10

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-32332-8

  • Online ISBN: 978-3-211-32509-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics