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Akute vaskuläre Erkrankungen

Dissektionen hirnversorgender Arterien

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DNP - Der Neurologe und Psychiater Aims and scope

Zusammenfassung

Die Mechanismen, die zu einer spontanen Dissektion hirnversorgender Arterien führen, sind bislang unzureichend verstanden. Es handelt sich um eine multifaktorielle Erkrankung, die nach aktuellen Vorstellungen auf einer präexistenten Vaskulopathie, also einer strukturellen oder metabolisch-entzündlichen Erkrankung des Gefäßsystems beruht, und zu der weitere Faktoren hinzukommen müssen, um das akute Ereignis der Entstehung eines spontanen Hämatoms in der Gefäßwand herbeizuführen. Die systemische Thrombolysetherapie innerhalb von 4,5 Stunden ist auch bei Dissektionspatienten ohne zusätzliches Blutungsrisiko möglich.

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Literatur

  1. Friedman WA, Day AL, Quisling RG, Sypert GW, Rhoton AL Jr. Cervical carotid dissecting aneurysms. Neurosurg 1980;7:207–214

    Article  CAS  Google Scholar 

  2. Schievink WI. Spontaneous dissection of the carotid and vertebral arteries. N Engl J Med 2001; 344: 898–906.

    Article  CAS  PubMed  Google Scholar 

  3. Debette S, Leys D. Cervical-artery dissections: predisposing factors, diagnosis, and outcome. Lancet Neurol. 2009a;8:668–678.

    Article  Google Scholar 

  4. Völker W, Dittrich R, Grewe S, Nassenstein I, Csiba L, Herczeg L, Borsay BA, Robenek H, Kuhlenbäumer G, Ringelstein EB. The outer arterial wall layers are primarily affected in spontaneous cervical artery dissection. Neurology. 2011;76:1463–1471.

    Article  PubMed  Google Scholar 

  5. Ringelstein EB, Dittrich R, Sitzer M, Arnold M, Haring HP. Spontane Dissektionen der extrakraniellen und intrakraniellen hirnversorgenden Arterien. In Diener HC, Leitlinien für Diagnostik und Therapie in der Neurologie 2012. (www.dgn.org)

  6. Miller PR, Fabian TC, Croce MA, Cagiannos C, Williams JS, Vang M, Qaisi WG, Felker RE, Timmons SD. Prospective screening for blunt cerebrovascular injuries: analysis of diagnostic modalities and outcomes. Ann Surg. 2002;236:386–93.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Berne JD, Cook A, Rowe SA, Norwood SH. A multivariate logistic regression analysis of risk factors for blunt cerebrovascular injury. J Vasc Surg. 2010;51:57–64.

    Article  PubMed  Google Scholar 

  8. Stein D, Boswell S, Sliker CW, Lui FY, Scalea TM: Blunt Cerebrovascular Injuries: Does Treatment Always Matter? J Trauma 2009;66:132–144.

    Article  PubMed  Google Scholar 

  9. Engelter ST, Grond-Ginsbach C, Metso TM, Metso AJ, Kloss M, Debette S, Leys D, MD Grau A, Dallongeville J, Bodenant M, Samson Y, Caso V, Pezzini A, Bonati LH, Thijs V, Gensicke H, Martin JJ, Bersano A, Touzé E, Tatlisumak T, Lyrer PA, Brandt T, for the Cervical Artery Dissection and Ischemic Stroke Patients (CADISP) Study Group: Cervical artery dissection. trauma and other potential mechanical trigger events. Neurology 2013;;80:1950–1957

    Article  PubMed  Google Scholar 

  10. Lee VH, Brown Jr RD, Mandrekar JN, Mokri B. Incidence and outcome of cervical artery dissection: a population-based study. Neurology 2006; 67: 1809–1812.

    Article  PubMed  Google Scholar 

  11. Baumgartner RW, Arnold M, Baumgartner I, Mosso M, Gönner F, Studer A, Schroth G, Schuknecht B, Sturzenegger M. Carotid dissection with and without ischemic events: local symptoms and cerebral artery findings. Neurology 2001;57:827–832.

    Article  CAS  PubMed  Google Scholar 

  12. Arnold M, Bousser MG, Fahrni G, Fischer U, Georgiadis D, Gandjour J, Benninger D, Sturzenegger M, Mattle HP, Baumgartner RW. Vertebral artery dissection: presenting findings and predictors of outcome. Stroke 2006; 37: 2499–2503.

    Article  PubMed  Google Scholar 

  13. Bevan H, Sharma K, Bradley W. Stroke in young adults. Stroke 1990; 21: 382–386.

    Article  CAS  PubMed  Google Scholar 

  14. Lisovoski F, Rousseaux P. Cerebral infarction in young people. A study of 148 patients with early cerebral angiography. J Neurol Neurosurg Psychiatry 1991; 54: 576–579.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  15. Bogousslavsky J, Pierre P. Ischemic stroke in patients under age 45. Neurol Clin 1992; 10: 113–124.

    CAS  PubMed  Google Scholar 

  16. Schievink WI, Mokri B, Piepgras DG. Spontaneous dissection of cervicocephalic arteries in childhood and adolescence. Neurology 1994; 44: 1607–1612.

    Article  CAS  PubMed  Google Scholar 

  17. Dziewas R, Konrad C, Dräger B, Evers S, Besselmann M, Lüdemann P, Kuhlenbäumer G, Stögbauer F, Ringelstein EB. Cervical artery dissection — clinical features, risk factors, therapy and outcome in 126 patients. J Neurol 2003; 250: 1179–1184.

    Article  PubMed  Google Scholar 

  18. Nedeltchev K, der Maur TA, Georgiadis D, Arnold M, Caso V, Mattle HP, et al. Ischaemic stroke in young adults: predictors of outcome and recurrence. J Neurol Neurosurg Psychiatry 2005;76:191–195.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Arauz A, Hoyos L, Espinoza C, Cantu C, Barinagarrementeria F, Roman G. Dissection of cervical arteries: Long-term follow-up study of 130 consecutive cases. Cerebrovasc Dis 2006;22:150–154.

    Article  PubMed  Google Scholar 

  20. Arnold M, Nedeltchev K, Sturzenegger M, Schroth G, Loher TJ, Stepper F, Remonda L, Bassetti C, Mattle HP. Thrombolysis in patients with acute stroke caused by cervical artery dissection: analysis of 9 patients and review of the literature. Arch Neurol 2002;59:549–553.

    Article  PubMed  Google Scholar 

  21. Baracchini C, Tonello S, Meneghetti G, Ballota E. Neurosonographic monitoring of 105 spontaneous cervical artery dissections: a prospective study. Neurology 2010; 75: 1864–1870

    Article  PubMed  Google Scholar 

  22. Völker W, Kuhlenbäumer G, Dittrich R, Appenzeller S, Grewe S, Maintz D, Heindel W, Grotemeyer KH, Ringelstein EB: Two Sets of identical twins with cervical artery dissection concordant for temporal artery pathology. Neurology 2008b;71;1035–1037.

    Article  Google Scholar 

  23. de Bray JM, Marc G, Pautot V, Vielle B, Pasco A, Lhoste P, Dubas F. Fibromuscular dysplasia may herald symptomatic recurrence of cervical artery dissection. Cerebrovasc Dis. 2007;23:448–452.

    Article  PubMed  Google Scholar 

  24. Dittrich R, Nassenstein I, Bachmann R, Maintz D, Nabavi DG, Heindel W, Kuhlenbäumer G, Ringelstein EB: Polyarterial clustered recurrence of cervical artery dissection seems to be the rule. Neurology 2007a;69:180–186.

    Article  CAS  Google Scholar 

  25. Dittrich R, Heidbreder A, Rohsbach D, Schmalhorst J, Nassenstein I, Maintz D, Ringelstein EB, Nabavi DG, Kuhlenbäumer G. Connective tissue and vascular phenotype in patients with cervical artery dissection. Neurology. 2007b;68:2120–4.

    Article  CAS  Google Scholar 

  26. Rothwell DM, Bondy SJ, Williams JI. Chiropractic manipulation and stroke: a population-based case-control study. Stroke. 2001;32:1054–60.

    Article  CAS  PubMed  Google Scholar 

  27. Rubinstein SM, Peerdeman SM, van Tulder MW, Riphagen I, Haldeman S. A systematic review of the risk factors for cervical artery dissection. Stroke. 2005;36:1575–80.

    Article  PubMed  Google Scholar 

  28. Fassett DR, Dailey AT, Vaccaro AR. Vertebral artery injuries associated with cervical spine injuries: a review of the literature. J Spinal Disord Tech. 2008;21:252–8.

    Article  PubMed  Google Scholar 

  29. Inamasu J, Guiot BH. Vertebral artery injury after blunt cervical trauma: an update. Surg Neurol. 2006;65:238–45.

    Article  PubMed  Google Scholar 

  30. Schievink WI, Debette S. Etiology of cervical artery dissections: The writing is in the wall Neurology 2011;76;1452–1453

    Article  PubMed  Google Scholar 

  31. Sasaki O, Ogawa H, Koike T, Koizumi T, Tanaka R. A clinicopathological study of dissecting aneurysms of the intracranial vertebral artery. J Neurosurg. 1991;75:874–82.

    Article  CAS  PubMed  Google Scholar 

  32. Brandt T, Hausser I, Orberk E, Grau A, Hartschuh W, Anton-Lamprecht I, Hacke W. Ultrastructural connective tissue abnormalities in patients with spontaneous cervicocerebral artery dissections. Ann Neurol. 1998;44:281–5.

    Article  CAS  PubMed  Google Scholar 

  33. Müller BT, Luther B, Hort W, Neumann-Haefelin T, Aulich A, Sandmann W. Surgical treatment of 50 carotid dissections: indications and results. J Vasc Surg. 2000;31:980–8.

    Article  PubMed  Google Scholar 

  34. Völker W, Ringelstein EB, Dittrich R, Maintz D, Nassenstein I, Heindel W, Grewe S, Kuhlenbäumer G. Morphometric analysis of collagen fibrils in skin of patients with spontaneous cervical artery dissection. J Neurol Neurosurg Psychiatry. 2008a;79:1007–12.

    Article  Google Scholar 

  35. Bachmann R, Nassenstein I, Kooijman H, Dittrich R, Kugel H, Niederstadt T, Kuhlenbäumer G, Ringelstein EB, Krämer S, Heindel W. Spontaneous acute dissection of the internal carotid artery: highresolution magnetic resonance imaging at 3.0 tesla with a dedicated surface coil. Invest Radiol 2006;41:105–111.

    Article  PubMed  Google Scholar 

  36. Leys D, Lucas C, Gobert M, Deklunder G, Pruvo JP. Cervical artery dissections. Eur Neurol. 1997;37:3–12.

    Article  CAS  PubMed  Google Scholar 

  37. Touzé E, Gauvrit JY, Moulin T, Meder JF, Bracard S, Mas JL; Multicenter Survey on Natural History of Cervical Artery Dissection. Risk of stroke and recurrent dissection after a cervical artery dissection: a multicenter study. Neurology. 2003;61:1347–51.

    Article  PubMed  Google Scholar 

  38. Pelkonen O, Tikkakoski T, Leinonen S, Pyhtinen J, Lepojärvi M, Sotaniemi K. Extracranial internal carotid and vertebral artery dissections: angiographic spectrum, course and prognosis. Neuroradiology. 2003;45:71–7.

    CAS  PubMed  Google Scholar 

  39. Pezzini A, Del Zotto E, Archetti S, Negrini R, Bani P, Albertini A, Grassi M, Assanelli D, Gasparotti R, Vignolo LA, Magoni M, Padovani A. Plasma homocysteine concentration, C677T MTHFR genotype, and 844ins68bp CBS genotype in young adults with spontaneous cervical artery dissection and atherothrombotic stroke. Stroke. 2002;33:664–9.

    Article  CAS  PubMed  Google Scholar 

  40. Arauz A, Hoyos L, Cantú C, Jara A, Martínez L, García I, Fernández Mde L, Alonso E. Mild hyperhomocysteinemia and low folate concentrations as risk factors for cervical arterial dissection. Cerebrovasc Dis. 2007;24:210–4.

    Article  CAS  PubMed  Google Scholar 

  41. Longoni M, Grond-Ginsbach C, Grau AJ, Genius J, Debette S, Schwaninger M, Ferrarese C, Lichy C. The ICAM-1 E469K gene polymorphism is a risk factor for spontaneous cervical artery dissection. Neurology. 2006;66:1273–5.

    Article  CAS  PubMed  Google Scholar 

  42. von Pein F, Välkkilä M, Schwarz R, Morcher M, Klima B, Grau A, Ala-Kokko L, Hausser I, Brandt T, Grond-Ginsbach C. Analysis of the COL3A1 gene in patients with spontaneous cervical artery dissections. J Neurol.2002;249:862–6.

    Article  Google Scholar 

  43. Debette S, Metso TM, Pezzini A, et al. CADISP-genetics: an International project searching for genetic risk factors of cervical artery dissections. Int J Stroke 2009b;4:224–230.

    Article  CAS  Google Scholar 

  44. Grau Armin J., MD; Tobias Brandt, MD; Florian Buggle, MD; Erdem Orberk, MD; Joannis Mytilineos, MD; Egon Werle, MD; Christian Conradt, PhD; Martin Krause, MD; Ralph Winter, MD; Werner Hacke, MD Association of Cervical Artery Dissection With Recent Infection. Arch Neurol 1999; 56:851–856

  45. Debette S, Grond-Ginsbach C, Bodenant M, Kloss M, Engelter S, Metso T, Pezzini A, Brandt T, Caso V, Touzé E, Metso A, Canaple S, Abboud S, Giacalone G, Lyrer P, Del Zotto E, Giroud M, Samson Y, Dallongeville J, Tatlisumak T, Leys D, Martin JJ; Cervical Artery Dissection Ischemic Stroke Patients (CADISP) Group. Differential features of carotid and vertebral artery dissections: the CADISP study. Neurology. 2011;77:1174–81.

    Article  CAS  PubMed  Google Scholar 

  46. Benninger DH, Herrmann FR, Georgiadis D, Kretschmer R, Sarikaya H, Schiller A, Baumgartner RW. Increased prevalence of hyperhomocysteinemia in cervical artery dissection causing stroke: a case-control study. Cerebrovasc Dis. 2009;27:241–6.

    Article  CAS  PubMed  Google Scholar 

  47. Tzourio C, Benslamia L, Guillon B, Aïdi S, Bertrand M, Berthet K, Bousser MG. Migraine and the risk of cervical artery dissection: a case-control study. Neurology. 2002;59:435–7.

    Article  CAS  PubMed  Google Scholar 

  48. Chen M, Caplan L. Intracranial dissections. Front Neurol Neurosci. 2005;20:160–173.

    Article  CAS  PubMed  Google Scholar 

  49. Yamaura A, Ono J, Hirai S. Clinical picture of intracranial non-traumatic dissecting aneurysm. Neuropathology 2000; 20: 85–90.

    Article  CAS  PubMed  Google Scholar 

  50. Yamaura A, Ono J. Current diagnosis and treatment of intracranial dissecting aneurysms. Neurosurg Q 1994; 4: 67–81.

    Article  Google Scholar 

  51. Pelkonen O, Tikkakoski T, Pyhtinen J, Sotaniemi K: Cerebral CT and MRI findings in cervicocephalic artery dissection. Acta Radiol 2004;45:259–65

    Article  CAS  PubMed  Google Scholar 

  52. Metso TM, Metso AJ, Helenius J, Haapaniemi E, Salonen O, Porras M, Hernesniemi J, Kaste K, Tatlisumak T: Prognosis and Safety of Anticoagulation in Intracranial Artery Dissections in Adults. Stroke. 2007;38:1837–1842.

    Article  CAS  PubMed  Google Scholar 

  53. Müllges W, Ringelstein EB, Leibold M. Non-invasive diagnosis of internal carotid artery dissections. J Neurol Neurosurg Psychiatry 1992;55:98–104.

    Article  PubMed Central  PubMed  Google Scholar 

  54. Kirsch E, Kaim A, Engelter S, Lyrer P, Stock KW, Bongartz G, Radü EW. MR angiography in internal carotid artery dissection: improvement of diagnosis by selective demonstration of the intramural haematoma. Neuroradiology 1998;40:704–709.

    Article  CAS  PubMed  Google Scholar 

  55. Fiebach J, Brand T, Knauth M, Jansen O. MRI with fat suppression in the visualization of wall hematoma in spontaneous dissection of the internal carotid artery. Fortschr Röntgenstr 1999;171: 290–293.

    Article  CAS  Google Scholar 

  56. Bachmann R, Nassenstein I, Kooijman H, Dittrich R, Stehling C, Kugel H, Niederstadt T, Kuhlenbäumer G, Ringelstein EB, Krämer S, Heindel W. High resolution magnetic resonance imaging at 3.0 tesla in the short-term follow-up of patients with proven cervical artery dissection. Invest Radiol 2007;42:460–466.

    Article  PubMed  Google Scholar 

  57. Naggara O, Oppenheim C, Toussaint JF, Calvet D, Touze E, Mas JL, Meder JF. Asymptomatic spontaneous acute vertebral artery dissection: diagnosis by high-resolution magnetic resonance images with a dedicated surface coil. Eur Radiol. 2007;17:2434–2435.

    Article  PubMed  Google Scholar 

  58. de Bray JM, Lhoste P, Dubas F, Emlie J, Saumet JL. Ultrasonic features of extracranial carotid dissections: 47 cases studied by angiography. J Ultrasound Med 1994;13:659–664.

    PubMed  Google Scholar 

  59. Steinke W, Rautenberg W, Schwartz A, Hennerici M. Noninvasive monitoring of internal carotid artery dissection. Stroke 1994;25:998–1005.

    Article  CAS  PubMed  Google Scholar 

  60. Sturzenegger M. Spontaneous internal carotid artery dissection: early diagnosis and management in 44 patients. J Neurol 1995;242: 231–238.

    Article  CAS  PubMed  Google Scholar 

  61. Alecu et al. Duplex Scanning Diagnosis of Internal Carotid Artery Dissections. A Case Control Study. Cerebrovasc Dis 2007;23:441–447

    Article  CAS  PubMed  Google Scholar 

  62. Nebelsieck J, Sengelhoff C, Nassenstein I, Maintz D, Kuhlenbäumer G, Nabavi DG, Ringelstein EB, Dittrich R. Sensitivity of neurovascular ultrasound for the detection of spontaneous cervical artery dissection. J Clin Neurosci. 2009;16:79–82.

    Article  CAS  PubMed  Google Scholar 

  63. Benninger DH, Baumgartner RW. Ultrasound diagnosis of cervical artery dissection. Front Neurol Neurosci 2006;21:70–84.

    Article  CAS  PubMed  Google Scholar 

  64. Dittrich R, Dziewas R, Ritter MA, Kloska SP, Bachmann R, Nassenstein I, Kuhlenbaumer G, Heindel W, Ringelstein EB, Nabavi DG. Negative ultrasound findings in patients with cervical artery dissections. Negative ultrasound in CAD. J Neurol 2006;253:424–433.

    Article  CAS  PubMed  Google Scholar 

  65. Sengelhoff C, Nebelsieck J, Nassenstein I, Maintz D, Nabavi DG, Kuhlenbaeumer G, Ringelstein EB, Dittrich R. Neurosonographical follow-up in patients with spontaneous cervical artery dissection. Neurol Res. 2008;30:687–689.

    Article  PubMed  Google Scholar 

  66. Georgiadis D, Lanczik O, Schwab S, Engelter S, Sztajzel R, Arnold M, Siebler M, Schwarz S, Lyrer P, Baumgartner RW. IV thrombolysis in patients with acute stroke due tospontaneous carotid dissection. Neurology 2005;64:1612–1614.

    Article  CAS  PubMed  Google Scholar 

  67. Zinkstok SM, Vergouwen MD, Engelter ST, Lyrer PA, Bonati LH, Arnold M, Mattle HP, Fischer U, Sarikaya H, Baumgartner RW, Georgiadis D, Odier C, Michel P, Putaala J, Griebe M, Wahlgren N, Ahmed N, van Geloven N, de Haan RJ, Nederkoorn PJ. Safety and functional outcome of thrombolysis in dissection-related ischemic stroke: a meta-analysis of individual patient data. Stroke. 2011;42:2515–2520.

    Article  PubMed  Google Scholar 

  68. Goyal MS, Derdeyn CP. The diagnosis and management of supraaortic arterial dissections. Curr Opin Neurol. 2009;22:80–89.

    Article  PubMed  Google Scholar 

  69. Engelter ST, Brandt T, Debette S, Caso V, Lichy C, Pezzini A, Abboud S, Bersano A, Dittrich R, Grond-Ginsbach C, Hausser I, Kloss M, Grau AJ, Tatlisumak T, Leys D, Lyrer PA; for the Cervical Artery Dissection in Ischemic Stroke Patients (CADISP) Study Group. Antiplatelets versus anticoagulation in cervical artery dissection. Stroke. 2007;38:2605–2611.

    Article  PubMed  Google Scholar 

  70. Menon R, Kerry S, Norris JW, Markus HS. Treatment of cervical artery dissection: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2008;79:1122–1127.

    Article  CAS  PubMed  Google Scholar 

  71. Georgiadis D, Arnold M, von Buedingen HC, Valko P, Sarikaya H, Rousson V, Mattle HP, Bousser MG, Baumgartner RW. Aspirin vs anticoagulation in carotid artery dissection: a study of 298 patients. Neurology. 2009;72:1810–1815.

    Article  CAS  PubMed  Google Scholar 

  72. Eikelboom JW, Weitz JI. New anticoagulants. Circulation. 2010;121(13):1523–1532.

    Article  PubMed  Google Scholar 

  73. Nedeltchev K, Bickel S, Arnold M, Sarikaya H, Georgiadis D, Sturzenegger M, Mattle HP, Baumgartner RW. Recanalization of spontaneous carotid artery dissection. Stroke. 2009;40:499–504.

    Article  PubMed  Google Scholar 

  74. Guillon B, Levy C, Bousser MG. Internal carotid artery dissection: an update. J Neur Sci. 1998; 153: 146–158.

    Article  CAS  Google Scholar 

  75. Benninger DH, Gandjour J, Georgiadis D, Stöckli E, Arnold M, Baumgartner RW. Benign long-term outcome of conservatively treated cervical aneurysms due to carotid dissection. Neurology. 2007;69:486–487.

    Article  CAS  PubMed  Google Scholar 

  76. Guillon B, Brunereau L, Biousse V, Djouhri H, Lévy C, Bousser MG. Long-term follow-up of aneurysms developed during extracranial internal carotid artery dissection. Neurology 1999;53:117–122.

    Article  CAS  PubMed  Google Scholar 

Weiterführende Literatur

  1. Arnold M, Pannier B, Chabriat H, Nedeltchev K, Stapf C, Buffon F, Crassard I, Thomas F, Guize L, Baumgartner RW, Bousser MG. Vascular risk factors and morphometric data in cervical artery dissection: a case-control study. J Neurol Neurosurg Psychiatry. 2009;80:232–234.

    Article  CAS  PubMed  Google Scholar 

  2. Arnold M, Kurmann R, Galimanis A, Sarikaya H, Stapf C, Gralla J, Georgiadis D, Fischer U, Mattle HP, Bousser MG, Baumgartner RW. Differences in demographic characteristics and risk factors in patients with spontaneous vertebral artery dissections with and without ischemic events. Stroke. 2010;41:802–804.

    Article  PubMed  Google Scholar 

  3. Chen C, Tseng Y, Lee T, Hsu HL, See LC. Multisection CT angiography compared with catheter angiography in diagnosing vertebral artery dissection. AJNR Am J Neuroradiol 2004; 25:769–774.

    PubMed  Google Scholar 

  4. Leclerc X, Godefroy O, Salhi A, Lucas C, Leys D, Pruvo JP. Helical CT for the diagnosis of extracranial internal carotid artery dissection. Stroke 1996; 27:461–466.

    Article  CAS  PubMed  Google Scholar 

  5. Völker W, Besselmann M, Dittrich R, Nabavi D, Konrad C, Dziewas R, Evers S, Grewe S, Krämer SC, Bachmann R, Stögbauer F, Ringelstein EB, Kuhlenbäumer G. Generalized arteriopathy in patients with cervical artery dissection. Neurology. 2005;64:1508–13.

    Article  PubMed  Google Scholar 

  6. Zuber M, Meary E, Meder J, Mas J. Magnetic resonance imaging and dynamic CT scan in cervical artery dissections. Stroke 1994; 25:576–581.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Albert-Schweitzer-Campus 1, 48129, Münster, Deutschland

    Erich Bernd Ringelstein (Medizinische Fakultät Münster)

  2. Klinikum Herford, Klinik für Neurologie, Schwarzenmoorstraße 70, 32049, Herford, Deutschland

    Matthias Sitzer

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Ringelstein, E.B., Sitzer, M. Dissektionen hirnversorgender Arterien. DNP 15, 38–47 (2014). https://doi.org/10.1007/s15202-014-0940-5

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