Document Detail


Management and clinical outcome of acute basilar artery dissection.
MedLine Citation:
PMID:  18687744     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: There have been inconsistencies on the prognosis and controversies as to the proper management of acute basilar artery dissection. The aim of this study was to evaluate acute basilar artery dissection and its outcome after management. MATERIALS AND METHODS: A total of 21 patients (mean age, 53 years; range, 24-78 years) with acute basilar artery dissection were identified between January 2001 and October 2007. Clinical presentation, management, and outcomes were retrospectively evaluated. RESULTS: The patients presented with subarachnoid hemorrhage (n = 10), brain stem ischemia (n = 10), or stem compression sign (n = 1). Ruptured basilar artery dissections were treated by stent placement with coiling (n = 4), single stent placement (n = 3), or conservatively (n = 3). Of the patients treated with endovascular technique, 6 had favorable outcome (modified Rankin scale [mRS], 0-2) and the remaining patient, who was treated by single stent placement, died from rebleeding. All 3 conservatively managed patients experienced rebleeding, of whom 2 died and the other was moderately disabled. Unruptured basilar artery dissections were treated conservatively (n = 7) or by stent placement (n = 4). Of the patients with unruptured basilar artery dissection, 9 had favorable outcome and the remaining 2 patients, both of whom were conservatively managed, had poor outcome because of infarct progression. The group with the ruptured basilar artery dissection revealed a higher mortality rate than the group with the unruptured dissection (30% vs 0%). The group treated with endovascular means revealed more favorable outcome than the group that was treated with conservative measures (90.9% vs 50%). CONCLUSION: The ruptured basilar artery dissections were at high risk for rebleeding, resulting in a grave outcome. Stent placement with or without coiling may be considered to prevent rebleeding in ruptured basilar dissections and judiciously considered in unruptured dissections with signs of progressive brain stem ischemia.
Authors:
B M Kim; S H Suh; S I Park; Y S Shin; E C Chung; M H Lee; E J Kim; J S Koh; H-S Kang; H G Roh; Y S Won; P-W Chung; Y-B Kim; B C Suh
Related Documents :
7789384 - Transoesophageal echocardiographic follow-up of patients with surgically treated aortic...
1772764 - Spontaneous dissecting aneurysm of the common iliac artery.
3968164 - Distal and proximal dissection of an abdominal aortic aneurysm.
3675054 - Preoperative evaluation of the thoracic aorta using mri and angiography.
11505324 - Modification of surgical aortoatrial shunts for inaccessible bleeding in aortic surgery...
16632804 - The accuracy of the central landmark used for central venous catheterization of the int...
Publication Detail:
Type:  Journal Article     Date:  2008-08-07
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  29     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-11-14     Completed Date:  2009-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1937-41     Citation Subset:  IM    
Affiliation:
Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Aneurysm, Dissecting / diagnosis*,  therapy*
Angiography / methods*
Female
Humans
Intracranial Aneurysm / diagnosis*,  therapy*
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Young Adult

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


Previous Document:  Frequency and topographic distribution of brain lesions in pediatric cerebral venous thrombosis.
Next Document:  Analysis of 11C-methionine uptake in low-grade gliomas and correlation with proliferative activity.