Clinical and Radiological Characteristics of Intracranial Artery Dissection Using Recently Proposed Diagnostic Criteria

Yuki Nakamura, Yoshitaka Yamaguchi, Naoki Makita, Yoshiaki Morita, Toshihiro Ide, Shinichi Wada, Tadataka Mizoguchi, Hajime Ikenouchi, Kaori Miwa, Kenichiro Yi, Kenichi Irie, Shun Shimohama, Masafumi Ihara, Kazunori Toyoda, Masatoshi Koga

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Data on the clinical and radiological characteristics of intracranial artery dissection (IAD) have remained limited. Our purpose was to reveal the clinical and radiological characteristics of IAD according to diagnostic criteria for IAD as recently reported by a group of international experts. Methods: Patients were retrospectively enrolled using a prospective single-center stroke registry between 2011 and 2016. Baseline characteristics and radiological findings including conventional magnetic resonance imaging (MRI) sequences, magnetic resonance angiography (MRA), high-resolution 3-dimensional T1-weighted imaging (HR-3D-T1WI), and digital subtraction angiography were reviewed. We performed statistical comparisons to determine which findings from which modalities are useful. Results: We identified 118 patients with suspected artery dissection, with 64 patients (median age, 51 [interquartile range, 45-56) years; 16 women) finally meeting the criteria for definite (n = 47), probable (n = 15), or possible (n = 2) idiopathic IAD. Ischemic stroke alone was found in 31 patients (48%) on admission. There were 36 patients (56%) suffering from hypertension and 39 (61%) with smoking history. The vertebral artery alone was the most affected in 42 patients (66%). Intramural hematoma (IMH) was more frequently detected on HR-3D-T1WI than on conventional MRI/MRA (odds ratio, 4.72; 95% confidence interval, 1.71-13.00). In 54 patients (84%), the modified Rankin Scale score after 3 months was 0-1. Conclusions: Male dominance and age at IAD onset were similar to previous studies, and more than half had hypertension and smoking history. We confirmed that HR-3D-T1WI is useful for detecting IMH in the diagnostic criteria.

Original languageEnglish
Pages (from-to)1691-1702
Number of pages12
JournalJournal of Stroke and Cerebrovascular Diseases
Volume28
Issue number6
DOIs
Publication statusPublished - 2019 Jun

Keywords

  • Criteria
  • high-resolution magnetic resonance imaging
  • intracranial artery dissection
  • intramural hematoma
  • stroke

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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