The diagnosis and management of supraaortic arterial dissections

Manu S Goyal; Colin P Derdeyn

doi:10.1097/WCO.0b013e328320d2b2

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The diagnosis and management of supraaortic arterial dissections

Journal article

Peer reviewed

The diagnosis and management of supraaortic arterial dissections

Manu S Goyal and Colin P Derdeyn

Current opinion in neurology, Vol.22(1), pp.80-89

02/2009

DOI: 10.1097/WCO.0b013e328320d2b2

PMID: 19165955

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Abstract

To review recent advances in understanding supraaortic arterial dissections and their diagnosis and management. Dissection of the supraaortic arteries, including the extracranial carotid and vertebral arteries and intracranial arteries, is increasingly identified as an important cause of stroke and subarachnoid hemorrhage. The most common cause likely involves minor trauma with preexisting arteriopathy. The imaging diagnosis of dissection is complicated by the wide range of pathological changes that occur after dissection. Modalities include ultrasound, magnetic resonance imaging and angiography, computed tomography angiography, and digital subtraction angiography. The choice of method is best tailored to each patient individually. Similarly, treatments may vary from antiplatelet medications to complex endovascular techniques. There are limited data to guide treating patients with strokes due to arterial dissections. Conservative management is likely optimal for most patients with cervical dissections, endovascular treatments being reserved for the rapidly deteriorating patient only. However, patients with subarachnoid hemorrhage due to rupture of a dissecting aneurysm require urgent endovascular or surgical treatment of the aneurysm. The diagnosis and management of supraaortic arterial dissections is complex, and a variable multidisciplinary approach will likely yield the best outcome.

Humans

Vertebral Artery Dissection - therapy

Subarachnoid Hemorrhage - pathology

Carotid Artery, Internal, Dissection - complications

Vertebral Artery Dissection - pathology

Diagnostic Imaging - methods

Carotid Artery, Internal, Dissection - diagnosis

Stroke - etiology

Carotid Artery, Internal, Dissection - therapy

Subarachnoid Hemorrhage - etiology

Vertebral Artery Dissection - diagnosis

Subarachnoid Hemorrhage - diagnosis

Vertebral Artery Dissection - complications

Carotid Artery, Internal, Dissection - pathology

Details

Title: Subtitle: The diagnosis and management of supraaortic arterial dissections
Creators: Manu S Goyal - Department of Neurology, Washington University School of Medicine, St Louis, Missouri 63110, USA
Colin P Derdeyn
Resource Type: Journal article
Publication Details: Current opinion in neurology, Vol.22(1), pp.80-89
Publisher: England
DOI: 10.1097/WCO.0b013e328320d2b2
PMID: 19165955
ISSN: 1350-7540
eISSN: 1473-6551
Language: English
Date published: 02/2009
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984020874902771

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