ATHEROMA BLEEDING - MRI DIFFERENTIAL-DIAGNOSIS OF DISSECTION OF THE CAROTID-ARTERY

Citation
A. Straube et al., ATHEROMA BLEEDING - MRI DIFFERENTIAL-DIAGNOSIS OF DISSECTION OF THE CAROTID-ARTERY, Nervenarzt, 68(8), 1997, pp. 671-673
Citations number
14
Language
TEDESCO
art.tipo
Article
Categorie Soggetti
Psychiatry,"Clinical Neurology
Journal title
ISSN journal
0028-2804
Volume
68
Issue
8
Year of publication
1997
Pages
671 - 673
Database
ISI
SICI code
0028-2804(1997)68:8<671:AB-MDO>2.0.ZU;2-4
Abstract
Improved methods of imaging the cerebral vascular system have increase d the detection of traumatic or spontaneous dissection of the vertebra l and carotid arteries. Especially MRI allows direct demonstration of intramural hematomas that are a sign of dissection of the vessel wall. We report on a patient who had an acute onset of dysarthria and monoc ular blurred vision, which recurred several times. Doppler ultrasound showed stenosis in both internal carotid arteries with reduced velocit y of the flow;angiography confirmed the stenosis, showing a long stret ch of stenosis (70%) of the right and a short stretch of stenosis (60% ) of the left internal carotid arteries. MRI demonstrated a narrowing of the lumen by an intramural mass, whose signal characteristics were typical for blood. The MRI findings were thus consistent with the diag nosis of a spontaneous dissection of the carotid arteries. Since the D oppler ultrasound follow-up showed no change during the following 3 da ys, we interpreted the MRI findings as an indication of bleeding in an atheroma. The carotid disobliteration, performed first on the left si de and later on the right side, confirmed this interpretation. Since s tenosis due to a fissuring atheroma or bleeding in an atheroma require s different therapy than a dissection, it is thus important to conside r the possible differential diagnosis in interpreting the MRI.