Document Detail

The many faces of intracranial arterial dissections.
MedLine Citation:
PMID:  20642889     Owner:  NLM     Status:  MEDLINE    
Intracranial arterial dissecting diseases are rare and challenging diseases with a high associated morbidity and mortality. Their common pathomechanic origin is related to blood entering the vessel wall via an endothelial and intimal tear. Depending on the fate of the thus established intramural hematoma, different symptoms may ensue including mass effect, subarachnoid hemorrhage or ischemia. If the mural hematoma ruptures all vascular layers of the intradural artery, a subarachnoid hemorrhagic will occur. If the intramural hematoma reopens distally into the parent vessel on the other hand, ischemic embolic events may happen following intramural clot formation. If the mural hematoma does neither open itself into the parent vessel nor into the subarachnoid space, the vessel wall may dilate leading to occlusion of perforator branches and local ischemia. Organization of the mural hematoma may result in a chronic dissecting process which may eventually lead to formation of a "giant partially thrombosed" aneurysm with thrombus of varying ages within the vessel wall, ingrowth of vasa vasorum and recurrent dissections with subsequent growth of the aneurysm from the periphery. Treatment strategies of these diseases should take the underlying pathomechanism into consideration and include, depending on the presentation medical treatment, parent vessel occlusion, flow reversal or diversion, surgical options or a combined treatment protocol.
T Krings; I-S Choi
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Publication Detail:
Type:  Journal Article; Review     Date:  2010-07-19
Journal Detail:
Title:  Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences     Volume:  16     ISSN:  1591-0199     ISO Abbreviation:  Interv Neuroradiol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-07-20     Completed Date:  2010-10-07     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  9602695     Medline TA:  Interv Neuroradiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  151-60     Citation Subset:  IM    
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
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MeSH Terms
Aneurysm, Dissecting / pathology*,  physiopathology*,  radiography
Brain Ischemia / pathology,  physiopathology,  radiography
Cerebral Angiography
Intracranial Aneurysm / pathology*,  physiopathology*,  radiography
Magnetic Resonance Angiography
Subarachnoid Hemorrhage / pathology*,  physiopathology*,  radiography

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