Early Diagnosis of Vertebral Dissecting Aneurysm: A Magnetic Resonance Angiography Study.

Abstract

Wereport a patient with dissecting aneurysm who presented with a sudden severe headache without any neurological symptoms. Although brain computed tomography (CT) scan and MRIwere negative, magnetic resonance angiography (MRA) showed a pseudocavity in a segment of the left vertebral artery. In addition, the dissecting wall of the left vertebral artery was clearly visualized in the original images of MRA.Our findings indicate that brain CT, MRIor cerebral angiography alone are sometimes inadequate for the diagnosis of vertebral dissecting aneurysm, and that MRAand its original images are necessary to establish the correct diagnosis.

Isolated Hypoglossal Nerve Palsy due to Compression by a Dissecting Vertebral Artery

“…While fat-suppressed T 1 axial MRI is accepted to be superior to MRA in demonstrating vessel wall haematoma in dissection [22] , MRA can still in many cases demonstrate the fi nd- ings in dissection adequately [23] . The main limitations of our case are the absence of axial T 1 MRI with fat suppression (not requested at the time of patient assessment), and imaging of the intracranial vasculature.…”

Headache and Spontaneous Vertebral Artery Dissection

“…It is often recommended to repeat MRAbecause of the high rate of recanalization of vessels within the first three months after the dissection. Somepatients can be treated with antiplatelet therapy alone, particularly those without other ischemic symptomsas reported by Ishihara et al (9).…”

State of the art: noninvasive imaging and management of neurovascular trauma

“…The MRA examinations in one study were performed on a low strength magnet (0.2T) and with noncontrast time-of-flight imaging only [26]. While the other two studies did not define their MRA protocols [108,117], new techniques/protocols involving gadolinium-enhanced MRA of the cervical and intracranial vessels may yield better resolution images, thereby increasing the diagnostic yield of the examination.…”