Document Detail


Low detection rate of craniocervical arterial dissection in children using time-of-flight magnetic resonance angiography: causes and strategies to improve diagnosis.
MedLine Citation:
PMID:  19351813     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Craniocervical arterial dissection is a frequent cause of childhood arterial ischemic stroke requiring prompt diagnosis and treatment. However, there is no universal guideline for diagnostic cerebrovascular imaging in children. We assessed the role of time-of-flight magnetic resonance angiography in diagnosing craniocervical arterial dissection. We included children (1 month to 18 years) with craniocervical arterial dissection and ischemic stroke from January 1998 to June 2007. Institutional protocol required magnetic resonance imaging (MRI)/ magnetic resonance angiography for all ischemic stroke cases and conventional cerebral angiography if magnetic resonance angiography showed any arteriopathy. Among 233 ischemic stroke cases, craniocervical arterial dissection was diagnosed in 13 patients (5.6%; 10 males), with a mean age of 7.5 years. Initial time-of-flight magnetic resonance angiography missed dissection in 8 patients (61.5%) because the neck vessels were not scanned (n = 2), of suboptimal technique (n = 3), and of diagnostic error (n = 3). T1 fat-saturated MRI and contrast-enhanced magnetic resonance angiography were not performed in 12 patients. If suspicion for arterial dissection is high, T1 fat-saturated neck imaging and contrast-enhanced magnetic resonance angiography should be considered to maximize detection.
Authors:
Marilyn A Tan; Gabrielle DeVeber; Adam Kirton; Logi Vidarsson; Daune MacGregor; Manohar Shroff
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Publication Detail:
Type:  Journal Article     Date:  2009-04-07
Journal Detail:
Title:  Journal of child neurology     Volume:  24     ISSN:  1708-8283     ISO Abbreviation:  J. Child Neurol.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-06     Completed Date:  2010-01-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8606714     Medline TA:  J Child Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1250-7     Citation Subset:  IM    
Affiliation:
Section of Neurology, Department of Pediatrics, Philippine General Hospital, Manila, Philippines. marlmd@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Angiography, Digital Subtraction
Brain / blood supply,  pathology
Brain Ischemia / etiology,  pathology
Cerebral Angiography / methods
Child
Child, Preschool
Diagnostic Errors / prevention & control
Female
Humans
Infant
Intracranial Arterial Diseases / complications,  diagnosis*,  pathology*
Magnetic Resonance Angiography / methods
Magnetic Resonance Imaging
Male
Prospective Studies
Retrospective Studies
Stroke / etiology,  pathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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