Cervicocerebral artery dissection

医学 放射科 数字减影血管造影 缺血 蛛网膜下腔出血 解剖(医学) 冲程(发动机) 颈动脉夹层 血管造影 磁共振成像 磁共振血管造影 心脏病学 内科学 机械工程 工程类
作者
Jorge G. Ortiz,Sean Ruland
出处
期刊:Current Opinion in Cardiology [Lippincott Williams & Wilkins]
卷期号:30 (6): 603-610 被引量:29
标识
DOI:10.1097/hco.0000000000000224
摘要

Purpose of review The purpose of this article is to review the epidemiology, pathophysiology, risk factors, clinical manifestations, diagnostic methods and current treatment options for cervicocerebral artery dissection (CCD). Recent findings CCD incidence has increased over time largely because of improvements in and increasing availability of noninvasive imaging. CCD can be detected on computed tomography angiography, MRI, magnetic resonance angiography, carotid duplex ultrasonography and conventional catheter-based digital subtraction angiography. Additionally, ischemic stroke treatment with intravenous tissue plasminogen-activator for patients with suspected CCD appears to be well tolerated and effective. Moreover, a randomized clinical trial has shown antiplatelet agents to be as effective as anticoagulants at preventing recurrent ischemia. Surgical and endovascular techniques can be considered particularly for patients presenting with intracranial arterial dissection causing subarachnoid hemorrhage, developing recurrent ischemia due to hemodynamic impairment and whose dissecting aneurysms cause brainstem compression. Summary CCD is an important and one of the most common causes of ischemic stroke in young patients without traditional vascular risk factors. Cases can occur shortly after trauma. However, spontaneous CCD is common and is associated with many genetic, acquired and anatomical risk factors. CCD should be detected early to avoid complications and prevent long-term disability.
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