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Acta Neurologica Belgica

, Volume 117, Issue 1, pp 299–302 | Cite as

Evolution of a large intracranial artery dissection on multimodal neuroimaging with spontaneous healing

  • Qiao Zuo
  • Yi-bin Fang
  • Rui Zhao
  • Jian-min Liu
  • Qing-hai HuangEmail author
Neuro-Images
  • 116 Downloads

Case presentation

A previously healthy 17-year-old male adolescent with intermittent mild headache for 4 years and more severe for a week was admitted to our hospital. A previous magnetic resonance imaging (MRI) performed 9 months prior to hospitalisation had shown no abnormalities (Fig.  1a). On current neuroimaging studies consisting of brain computed tomography (CT), MRI with magnetic resonance angiography (MRA), and digital subtraction angiography (DSA) examination, a large intracranial artery dissection (IAD) was detected. Given the lack of subarachnoid hemorrhage (SAH) or ischemia, and the perceived risk of endovascular or surgical treatment, preference was given to close clinical and radiological observation and antiplatelet medication for the patient and the dissection spontaneously healed over the next 8 months.

Keywords

Intracranial artery dissection Intramural hematoma Magnetic resonance imaging Magnetic resonance angiography Digital subtraction angiography 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

This study was approved by the Ethics Committee of Changhai Hospital.

Informed Consent

Informed consent was obtained from all individual participants.

References

  1. 1.
    Guillon B, Levy C, Bousser MG (1998) Internal carotid artery dissection: an update. J Neurol Sci 153(2):146–158CrossRefPubMedGoogle Scholar
  2. 2.
    Sikkema T, Uyttenboogaart M, Eshghi O, De Keyser J, Brouns R, van Dijk JM, Luijckx GJ (2014) Intracranial artery dissection. Eur J Neurol Off J Eur Fed Neurol Soc 21(6):820–826. doi: 10.1111/ene.12384 Google Scholar
  3. 3.
    Mahawish K, Durairaj R, Sharma AK (2010) Intracranial carotid artery dissection. Postgrad Med J 86(1013):190. doi: 10.1136/pgmj.2009.087015 CrossRefPubMedGoogle Scholar
  4. 4.
    Li SM, Yan B, Kaye A, Mitchell P, Dowling R, Collins M, Davis S (2011) Prognosis of intracranial dissection relates to site and presenting features. J Clin Neurosci 18(6):789–793. doi: 10.1016/j.jocn.2010.11.006 CrossRefPubMedGoogle Scholar
  5. 5.
    Krings T, Choi IS (2010) The many faces of intracranial arterial dissections. Interv Neuroradiol 16(2):151–160CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Kim TW, Choi HS, Koo J, Jung SL, Ahn KJ, Kim BS, Shin YS, Lee KS (2013) Intramural hematoma detection by susceptibility-weighted imaging in intracranial vertebral artery dissection. Cerebrovasc Dis 36(4):292–298. doi: 10.1159/000354811 CrossRefPubMedGoogle Scholar
  7. 7.
    Engelter ST, Traenka C, Von Hessling A, Lyrer PA (2015) Diagnosis and treatment of cervical artery dissection. Neurol Clin 33(2):421–441. doi: 10.1016/j.ncl.2014.12.002 CrossRefPubMedGoogle Scholar
  8. 8.
    Chen L, Yau I, deVeber G, Dirks P, Armstrong D, Krings T (2015) Evolution of a chronic dissecting aneurysm on magnetic resonance imaging in a pediatric patient. J Neurosurg Pediatr 15(2):192–196. doi: 10.3171/2014.10.PEDS14221 CrossRefPubMedGoogle Scholar
  9. 9.
    Teng MM, Nasir Qadri SM, Luo CB, Lirng JF, Chen SS, Chang CY (2003) MR imaging of giant intracranial aneurysm. J Clin Neurosci Off J Neurosurg Soc Australas 10(4):460–464Google Scholar
  10. 10.
    Kim CH, Son YJ, Paek SH, Han MH, Kim JE, Chung YS, Kwon BJ, Oh CW, Han DH (2006) Clinical analysis of vertebrobasilar dissection. Acta Neurochir (Wien) 148(4):395–404. doi: 10.1007/s00701-006-0742-4 CrossRefGoogle Scholar
  11. 11.
    Arnold M, Bousser MG, Fahrni G, Fischer U, Georgiadis D, Gandjour J, Benninger D, Sturzenegger M, Mattle HP, Baumgartner RW (2006) Vertebral artery dissection—presenting findings and predictors of outcome. Stroke J Cereb Circ 37(10):2499–2503. doi: 10.1161/01.Str.0000240493.88473.39 CrossRefGoogle Scholar
  12. 12.
    Mizutani T (2011) Natural course of intracranial arterial dissections. J Neurosurg 114(4):1037–1044. doi: 10.3171/2010.9.JNS10668 CrossRefPubMedGoogle Scholar
  13. 13.
    Mizutani T, Kojima H, Asamoto S (2004) Healing process for cerebral dissecting aneurysms presenting with subarachnoid hemorrhage. Neurosurgery 54(2):342–347. doi: 10.1227/01.Neu.0000103449.80484.7e CrossRefPubMedGoogle Scholar
  14. 14.
    Mitchell GM, McCann JJ, Rogers IW, Hickey MJ, Morrison WA, O’Brien BM (1996) A morphological study of the long-term repair process in experimentally stretched but unruptured arteries and veins. Br J Plast Surg 49(1):34–40CrossRefPubMedGoogle Scholar

Copyright information

© Belgian Neurological Society 2016

Authors and Affiliations

  • Qiao Zuo
    • 1
  • Yi-bin Fang
    • 1
  • Rui Zhao
    • 1
  • Jian-min Liu
    • 1
  • Qing-hai Huang
    • 1
    Email author
  1. 1.Department of Neurosurgery, Changhai HospitalSecond Military Medical UniversityShanghaiChina

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