Ultrasound findings in carotid artery dissection

Sturzenegger, Matthias; Mattle, Heinrich; Rivoir, Anita; Baumgartner, Ralf W.

doi:10.1212/wnl.45.4.691

Cited by 206 publications

(159 citation statements)

References 36 publications

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“…1 Several studies have shown the usefulness of Doppler ultrasonography in follow-up monitoring of CADs. 66,67 Doppler ultrasonography findings consistent with an internal CAD are well characterized. 1,69 Continuous wave Doppler velocimetry, standard duplex scanning, and color Doppler flow imaging have all been used in the diagnosis of CADs.…”

Section: Diagnosis Of Cadmentioning

confidence: 83%

“…Authors of small series only have reported the use of ultrasonography in the diagnosis and follow-up of CADs. 10,60,64,67,71 Duplex ultrasonography provides high-resolution real-time images of the CA bifurcation and proximal internal CA and has proved reliable in evaluating the presence and severity of atherosclerotic disease. Ultrasonography is noninvasive and more widely available than conventional angiography or MR angiography.…”

Section: Diagnosis Of Cadmentioning

confidence: 99%

“…64 Reported sensitivities for the detection of dissection have ranged from 93-100%. 64,67,68 Computed Tomography Angiography. Computed tomography angiography has been shown to have a high sensitivity for detecting CADs, especially soon after the ictus.…”

Section: Diagnosis Of Cadmentioning

confidence: 99%

“…61 There are no data from controlled studies on the safety of heparin, although several consecutive series have shown no significant side effects. 12,67 Caution should be exercised when anticoagulants are used in patients who have concurrent intracranial dissections, because of the risk of subarachnoid hemorrhage and a worsening of deficits after early anticoagulation. 20 The fear that anticoagulation or tissue plasminogen activator therapy will extend the dissection seems to be unfounded.…”

Section: Management Optionsmentioning

confidence: 99%

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Extracranial traumatic carotid artery dissections in children: a review of current diagnosis and treatment options

Chamoun

Mawad

Whitehead

et al. 2008

PED

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Object Currently, no diagnostic or treatment standards exist for extracranial carotid artery dissection (CAD) in children after trauma. The purpose of this study was to review and describe the characteristics, diagnosis, and treatment of this rather uncommon sequelae of pediatric trauma. Methods A systematic review of the literature was performed to examine the pertinent studies of traumatic extracranial carotid artery (CA) injuries in children. Results No randomized trials were identified; however, 19 case reports or small case series consisting of 34 pediatric patients were found in the literature. The diagnosis of CAD was made in 33 of 34 patients only after the onset of ischemic symptomatology. Twenty-four of 34 patients underwent cerebral angiography to confirm diagnosis; MR angiography affirmed the diagnosis in 6 of 34 patients. There was little published experience with CA ultrasonography or CT angiography for diagnosis. Thirty of 34 patients were treated with medical therapy or observation; 2 of 4 patients treated with observation alone died. There was little experience with open surgical treatment of CAD in the pediatric population, and there were no studies on the endovascular treatment of traumatic CAD in children. The literature does not support anticoagulation therapy over antiplatelet therapy. Conclusions As a result of this review of the literature, the authors propose the algorithms for the evaluation and treatment of traumatic extracranial CADs in children. These recommendations include utilizing MR angiography as a screening tool in cases in which the clinical suspicion of CAD is high, using conventional cerebral angiography to confirm the diagnosis, implementing antiplatelet therapy as initial medical management, and reserving endovascular stenting in cases of failed medical treatment.

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Section: Diagnosis Of Cadmentioning

confidence: 83%

Section: Diagnosis Of Cadmentioning

confidence: 99%

Section: Diagnosis Of Cadmentioning

confidence: 99%

Section: Management Optionsmentioning

confidence: 99%

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Extracranial traumatic carotid artery dissections in children: a review of current diagnosis and treatment options

Chamoun

Mawad

Whitehead

et al. 2008

PED

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“…[6][7][8]11 Carotid ultrasonography has also been suggested as an alternative screening modality as it is at least 93% sensitive, although this rate is operator dependant. 7,11,24,25,27 Ultimately, digital subtraction angiography is still considered the gold standard for diagnosing ICA dissection, although some have suggested that it should be reserved for diagnostic confirmation and/or endovascular intervention. 6,7 The danger of ICA dissection is ischemia, as 44%-67% of traumatic ICA dissections lead to delayed-onset stroke.…”

Section: Mode Of Injury In Traumatic Tiger Bitesmentioning

confidence: 99%

Traumatic tiger attack

Chum¹,

2011

PED

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Attacks on humans by large cats are uncommon occurrences and thus the principles of managing such injuries are not well documented. The authors here report the case of an 11-year-old boy who was mauled by a privately owned tiger. The attack resulted in multiple cranial lacerations and fractures, dissection of the internal carotid artery, and persistent neurological deficits. This case outlines the multiple sources of injury and pathology that can result from such an attack. Discussion is focused on the pattern of injury seen in large feline attacks and the treatment approach.

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