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.
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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 -