Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection

Stéphanie Debette; Annette Compter; Marc Antoine Labeyrie; Maarten Uyttenboogaart; Tina M. Metso; Jennifer J. Majersik; Barbara Goeggel-Simonetti; Stefan T. Engelter; Alessandro Pezzini; Philippe Bijlenga; Andrew M. Southerland; Olivier Naggara; Yannick Béjot; John W. Cole; Anne Ducros; Giacomo Giacalone; Sabrina Schilling; Peggy Reiner; Hakan Sarikaya; Janna C. Welleweerd; L. Jaap Kappelle; Gert Jan de Borst; Leo H. Bonati; Simon Jung; Vincent Thijs; Juan J. Martin; Tobias Brandt; Caspar Grond-Ginsbach; Manja Kloss; Tohru Mizutani; Kazuo Minematsu; James F. Meschia; Vitor M. Pereira; Anna Bersano; Emmanuel Touzé; Philippe A. Lyrer; Didier Leys; Hugues Chabriat; Hugh S. Markus; Bradford B. Worrall; Stéphane Chabrier; Ralph Baumgartner; Christian Stapf; Turgut Tatlisumak; Marcel Arnold; Marie Germaine Bousser

doi:10.1016/S1474-4422(15)00009-5

Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection

Stéphanie Debette, Annette Compter, Marc Antoine Labeyrie, Maarten Uyttenboogaart, Tina M. Metso, Jennifer J. Majersik, Barbara Goeggel-Simonetti, Stefan T. Engelter, Alessandro Pezzini, Philippe Bijlenga, Andrew M. Southerland, Olivier Naggara, Yannick Béjot, John W. Cole, Anne Ducros, Giacomo Giacalone, Sabrina Schilling, Peggy Reiner, Hakan Sarikaya, Janna C. WelleweerdL. Jaap Kappelle, Gert Jan de Borst, Leo H. Bonati, Simon Jung, Vincent Thijs, Juan J. Martin, Tobias Brandt, Caspar Grond-Ginsbach, Manja Kloss, Tohru Mizutani, Kazuo Minematsu, James F. Meschia, Vitor M. Pereira, Anna Bersano, Emmanuel Touzé, Philippe A. Lyrer, Didier Leys, Hugues Chabriat, Hugh S. Markus, Bradford B. Worrall, Stéphane Chabrier, Ralph Baumgartner, Christian Stapf, Turgut Tatlisumak, Marcel Arnold, Marie Germaine Bousser

Neurology

Research output: Contribution to journal › Review article › peer-review

170 Scopus citations

Abstract

Spontaneous intracranial artery dissection is an uncommon and probably underdiagnosed cause of stroke that is defined by the occurrence of a haematoma in the wall of an intracranial artery. Patients can present with headache, ischaemic stroke, subarachnoid haemorrhage, or symptoms associated with mass effect, mostly on the brainstem. Although intracranial artery dissection is less common than cervical artery dissection in adults of European ethnic origin, intracranial artery dissection is reportedly more common in children and in Asian populations. Risk factors and mechanisms are poorly understood, and diagnosis is challenging because characteristic imaging features can be difficult to detect in view of the small size of intracranial arteries. Therefore, multimodal follow-up imaging is often needed to confirm the diagnosis. Treatment of intracranial artery dissections is empirical in the absence of data from randomised controlled trials. Most patients with subarachnoid haemorrhage undergo surgical or endovascular treatment to prevent rebleeding, whereas patients with intracranial artery dissection and cerebral ischaemia are treated with antithrombotics. Prognosis seems worse in patients with subarachnoid haemorrhage than in those without.

Original language	English (US)
Pages (from-to)	640-654
Number of pages	15
Journal	The Lancet Neurology
Volume	14
Issue number	6
DOIs	https://doi.org/10.1016/S1474-4422(15)00009-5
State	Published - Jun 1 2015

ASJC Scopus subject areas

Clinical Neurology

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10.1016/S1474-4422(15)00009-5

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Debette, S., Compter, A., Labeyrie, M. A., Uyttenboogaart, M., Metso, T. M., Majersik, J. J., Goeggel-Simonetti, B., Engelter, S. T., Pezzini, A., Bijlenga, P., Southerland, A. M., Naggara, O., Béjot, Y., Cole, J. W., Ducros, A., Giacalone, G., Schilling, S., Reiner, P., Sarikaya, H., ... Bousser, M. G. (2015). Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection. The Lancet Neurology, 14(6), 640-654. https://doi.org/10.1016/S1474-4422(15)00009-5

Debette, S, Compter, A, Labeyrie, MA, Uyttenboogaart, M, Metso, TM, Majersik, JJ, Goeggel-Simonetti, B, Engelter, ST, Pezzini, A, Bijlenga, P, Southerland, AM, Naggara, O, Béjot, Y, Cole, JW, Ducros, A, Giacalone, G, Schilling, S, Reiner, P, Sarikaya, H, Welleweerd, JC, Kappelle, LJ, de Borst, GJ, Bonati, LH, Jung, S, Thijs, V, Martin, JJ, Brandt, T, Grond-Ginsbach, C, Kloss, M, Mizutani, T, Minematsu, K, Meschia, JF, Pereira, VM, Bersano, A, Touzé, E, Lyrer, PA, Leys, D, Chabriat, H, Markus, HS, Worrall, BB, Chabrier, S, Baumgartner, R, Stapf, C, Tatlisumak, T, Arnold, M & Bousser, MG 2015, 'Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection', The Lancet Neurology, vol. 14, no. 6, pp. 640-654. https://doi.org/10.1016/S1474-4422(15)00009-5

@article{09449e2fb84c4912b6502e1dce6085bc,

title = "Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection",

abstract = "Spontaneous intracranial artery dissection is an uncommon and probably underdiagnosed cause of stroke that is defined by the occurrence of a haematoma in the wall of an intracranial artery. Patients can present with headache, ischaemic stroke, subarachnoid haemorrhage, or symptoms associated with mass effect, mostly on the brainstem. Although intracranial artery dissection is less common than cervical artery dissection in adults of European ethnic origin, intracranial artery dissection is reportedly more common in children and in Asian populations. Risk factors and mechanisms are poorly understood, and diagnosis is challenging because characteristic imaging features can be difficult to detect in view of the small size of intracranial arteries. Therefore, multimodal follow-up imaging is often needed to confirm the diagnosis. Treatment of intracranial artery dissections is empirical in the absence of data from randomised controlled trials. Most patients with subarachnoid haemorrhage undergo surgical or endovascular treatment to prevent rebleeding, whereas patients with intracranial artery dissection and cerebral ischaemia are treated with antithrombotics. Prognosis seems worse in patients with subarachnoid haemorrhage than in those without.",

author = "St{\'e}phanie Debette and Annette Compter and Labeyrie, {Marc Antoine} and Maarten Uyttenboogaart and Metso, {Tina M.} and Majersik, {Jennifer J.} and Barbara Goeggel-Simonetti and Engelter, {Stefan T.} and Alessandro Pezzini and Philippe Bijlenga and Southerland, {Andrew M.} and Olivier Naggara and Yannick B{\'e}jot and Cole, {John W.} and Anne Ducros and Giacomo Giacalone and Sabrina Schilling and Peggy Reiner and Hakan Sarikaya and Welleweerd, {Janna C.} and Kappelle, {L. Jaap} and {de Borst}, {Gert Jan} and Bonati, {Leo H.} and Simon Jung and Vincent Thijs and Martin, {Juan J.} and Tobias Brandt and Caspar Grond-Ginsbach and Manja Kloss and Tohru Mizutani and Kazuo Minematsu and Meschia, {James F.} and Pereira, {Vitor M.} and Anna Bersano and Emmanuel Touz{\'e} and Lyrer, {Philippe A.} and Didier Leys and Hugues Chabriat and Markus, {Hugh S.} and Worrall, {Bradford B.} and St{\'e}phane Chabrier and Ralph Baumgartner and Christian Stapf and Turgut Tatlisumak and Marcel Arnold and Bousser, {Marie Germaine}",

note = "Funding Information: TMM reports grants from The Emil Aaltonen Foundation and Maud Kuistila Memorial Foundation; and grants from Helsinki University Central Hospital Research Fund, Biomedicum Helsinki Foundation, and Helsinki University Medical Foundation, outside the submitted work. AD is an employee of Cephalgia. VT reports other relationships from Boehringer Ingelheim, Medtronic, Pfizer, and Bayer, outside the submitted work. ET reports personal fees from BMS, Pfizer, Bayer, Boston Scientific, and Boehringer Ingelheim, outside the submitted work. HC reports personal fees from Johnson and Johnson and Lundbeck, outside the submitted work. TT reports grants from Boehringer Ingelheim and Mitsubishi Pharma, H Lundbeck A/S, Sanofi-Aventis, PhotoThera Inc, Mitsubishi Pharma, BrainsGate, Orion Pharma, Schering Plough, Bayer, Pfizer, Concentric Medical, Helsinki University Central Hospital, Sigrid Juselius Foundation, Liv och H{\"a}lsa Foundation, Biocenter Finland, Biocentrum Helsinki, European Union, Finnish Academy of Sciences, and from National Institutes of Health. TT reports personal fees from Bayer, Pfizer, Professio Finland, University of Helsinki, Finnish Medical Association, Finnish Neurological Association, and the University of Donau (Krems). TT reports other payments to his institution from Salus Ansvar Foundation Award, Finnish Medical Association Quality Award (2011 and 2014), and personal fees from other relationships from European Stroke Conference, European Federation of Neurological Societies Conference, European Stroke Organisation, University of Rostock, University of Bielefeld, Australia and New Zealand Stroke Society, Austrian Stroke Society, University of Leuven, University of Tarto, Nordic Stroke Conference, Polish Neuroscience Society, Greek Internal Medicine Society, University of Donau, Krems, Thrombolysis and Thrombectomy Acute Stroke Treatment Conference, World Stroke Conference, University of Bern, University of Tuebingen, German Psychological Society, outside the submitted work. MA reports personal fees (speaker's fee, advisory board honoraria) from Covidien, Boehringer Ingelheim, and BMS, outside the submitted work. MA reports research grants from Swiss National Science Foundation, Swiss Heart Foundation, SHIRE, Nestl{\'e} Health Services, outside the submitted work. SD is supported by the Agence Nationale de la Recherche. AC is supported by the Dutch Heart Foundation (2007/B45). JJMaj is supported by the National Institute of Health (U10 NS086606-01). AMS and BBW are both supported by the American Heart Association/American Stroke Association (AHA/ASA) National Clinical Research Program (AHA 3CRP141400001). HSM is supported by a National Institute of Health and Research senior investigator award. M-AL, MU, BG-S, STE, AP, PB, ON, YB, JWC, GG, SS, PR, HS, JCW, LJK, GJdB, LHB, SJ, JJMar, TB, CG-G, MK, TM, KM, JFM, VMP, AB, PAL, DL, SC, RB, CS, and M-GB declare no competing interests. Publisher Copyright: {\textcopyright} 2015 Elsevier Ltd.",

year = "2015",

month = jun,

day = "1",

doi = "10.1016/S1474-4422(15)00009-5",

language = "English (US)",

volume = "14",

pages = "640--654",

journal = "The Lancet Neurology",

issn = "1474-4422",

publisher = "Lancet Publishing Group",

number = "6",

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TY - JOUR

T1 - Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection

AU - Debette, Stéphanie

AU - Compter, Annette

AU - Labeyrie, Marc Antoine

AU - Uyttenboogaart, Maarten

AU - Metso, Tina M.

AU - Majersik, Jennifer J.

AU - Goeggel-Simonetti, Barbara

AU - Engelter, Stefan T.

AU - Pezzini, Alessandro

AU - Bijlenga, Philippe

AU - Southerland, Andrew M.

AU - Naggara, Olivier

AU - Béjot, Yannick

AU - Cole, John W.

AU - Ducros, Anne

AU - Giacalone, Giacomo

AU - Schilling, Sabrina

AU - Reiner, Peggy

AU - Sarikaya, Hakan

AU - Welleweerd, Janna C.

AU - Kappelle, L. Jaap

AU - de Borst, Gert Jan

AU - Bonati, Leo H.

AU - Jung, Simon

AU - Thijs, Vincent

AU - Martin, Juan J.

AU - Brandt, Tobias

AU - Grond-Ginsbach, Caspar

AU - Kloss, Manja

AU - Mizutani, Tohru

AU - Minematsu, Kazuo

AU - Meschia, James F.

AU - Pereira, Vitor M.

AU - Bersano, Anna

AU - Touzé, Emmanuel

AU - Lyrer, Philippe A.

AU - Leys, Didier

AU - Chabriat, Hugues

AU - Markus, Hugh S.

AU - Worrall, Bradford B.

AU - Chabrier, Stéphane

AU - Baumgartner, Ralph

AU - Stapf, Christian

AU - Tatlisumak, Turgut

AU - Arnold, Marcel

AU - Bousser, Marie Germaine

N1 - Funding Information: TMM reports grants from The Emil Aaltonen Foundation and Maud Kuistila Memorial Foundation; and grants from Helsinki University Central Hospital Research Fund, Biomedicum Helsinki Foundation, and Helsinki University Medical Foundation, outside the submitted work. AD is an employee of Cephalgia. VT reports other relationships from Boehringer Ingelheim, Medtronic, Pfizer, and Bayer, outside the submitted work. ET reports personal fees from BMS, Pfizer, Bayer, Boston Scientific, and Boehringer Ingelheim, outside the submitted work. HC reports personal fees from Johnson and Johnson and Lundbeck, outside the submitted work. TT reports grants from Boehringer Ingelheim and Mitsubishi Pharma, H Lundbeck A/S, Sanofi-Aventis, PhotoThera Inc, Mitsubishi Pharma, BrainsGate, Orion Pharma, Schering Plough, Bayer, Pfizer, Concentric Medical, Helsinki University Central Hospital, Sigrid Juselius Foundation, Liv och Hälsa Foundation, Biocenter Finland, Biocentrum Helsinki, European Union, Finnish Academy of Sciences, and from National Institutes of Health. TT reports personal fees from Bayer, Pfizer, Professio Finland, University of Helsinki, Finnish Medical Association, Finnish Neurological Association, and the University of Donau (Krems). TT reports other payments to his institution from Salus Ansvar Foundation Award, Finnish Medical Association Quality Award (2011 and 2014), and personal fees from other relationships from European Stroke Conference, European Federation of Neurological Societies Conference, European Stroke Organisation, University of Rostock, University of Bielefeld, Australia and New Zealand Stroke Society, Austrian Stroke Society, University of Leuven, University of Tarto, Nordic Stroke Conference, Polish Neuroscience Society, Greek Internal Medicine Society, University of Donau, Krems, Thrombolysis and Thrombectomy Acute Stroke Treatment Conference, World Stroke Conference, University of Bern, University of Tuebingen, German Psychological Society, outside the submitted work. MA reports personal fees (speaker's fee, advisory board honoraria) from Covidien, Boehringer Ingelheim, and BMS, outside the submitted work. MA reports research grants from Swiss National Science Foundation, Swiss Heart Foundation, SHIRE, Nestlé Health Services, outside the submitted work. SD is supported by the Agence Nationale de la Recherche. AC is supported by the Dutch Heart Foundation (2007/B45). JJMaj is supported by the National Institute of Health (U10 NS086606-01). AMS and BBW are both supported by the American Heart Association/American Stroke Association (AHA/ASA) National Clinical Research Program (AHA 3CRP141400001). HSM is supported by a National Institute of Health and Research senior investigator award. M-AL, MU, BG-S, STE, AP, PB, ON, YB, JWC, GG, SS, PR, HS, JCW, LJK, GJdB, LHB, SJ, JJMar, TB, CG-G, MK, TM, KM, JFM, VMP, AB, PAL, DL, SC, RB, CS, and M-GB declare no competing interests. Publisher Copyright: © 2015 Elsevier Ltd.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Spontaneous intracranial artery dissection is an uncommon and probably underdiagnosed cause of stroke that is defined by the occurrence of a haematoma in the wall of an intracranial artery. Patients can present with headache, ischaemic stroke, subarachnoid haemorrhage, or symptoms associated with mass effect, mostly on the brainstem. Although intracranial artery dissection is less common than cervical artery dissection in adults of European ethnic origin, intracranial artery dissection is reportedly more common in children and in Asian populations. Risk factors and mechanisms are poorly understood, and diagnosis is challenging because characteristic imaging features can be difficult to detect in view of the small size of intracranial arteries. Therefore, multimodal follow-up imaging is often needed to confirm the diagnosis. Treatment of intracranial artery dissections is empirical in the absence of data from randomised controlled trials. Most patients with subarachnoid haemorrhage undergo surgical or endovascular treatment to prevent rebleeding, whereas patients with intracranial artery dissection and cerebral ischaemia are treated with antithrombotics. Prognosis seems worse in patients with subarachnoid haemorrhage than in those without.

AB - Spontaneous intracranial artery dissection is an uncommon and probably underdiagnosed cause of stroke that is defined by the occurrence of a haematoma in the wall of an intracranial artery. Patients can present with headache, ischaemic stroke, subarachnoid haemorrhage, or symptoms associated with mass effect, mostly on the brainstem. Although intracranial artery dissection is less common than cervical artery dissection in adults of European ethnic origin, intracranial artery dissection is reportedly more common in children and in Asian populations. Risk factors and mechanisms are poorly understood, and diagnosis is challenging because characteristic imaging features can be difficult to detect in view of the small size of intracranial arteries. Therefore, multimodal follow-up imaging is often needed to confirm the diagnosis. Treatment of intracranial artery dissections is empirical in the absence of data from randomised controlled trials. Most patients with subarachnoid haemorrhage undergo surgical or endovascular treatment to prevent rebleeding, whereas patients with intracranial artery dissection and cerebral ischaemia are treated with antithrombotics. Prognosis seems worse in patients with subarachnoid haemorrhage than in those without.

UR - http://www.scopus.com/inward/record.url?scp=84929340831&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84929340831&partnerID=8YFLogxK

U2 - 10.1016/S1474-4422(15)00009-5

DO - 10.1016/S1474-4422(15)00009-5

M3 - Review article

C2 - 25987283

AN - SCOPUS:84929340831

VL - 14

SP - 640

EP - 654

JO - The Lancet Neurology

JF - The Lancet Neurology

SN - 1474-4422

IS - 6

ER -

Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection

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