This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (10)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Cerebrovascular Disease  • Stroke  • Radiologic Imaging  • Magnetic Resonance Imaging  • Alert me on articles by topic  Social Bookmarking   What's this?

Sebastian Koch, MD; Alejandro A. Rabinstein, MD; Jose G. Romano, MD; Alejandro Forteza, MD

Arch Neurol. 2004;61:510-512.

Background  Acute multiple brain infarction pattern on diffusion-weighted imaging is associated with arterial or cardiac sources of embolism.

Objectives  To review the diffusion-weighted imaging characteristics of patients with strokes secondary to internal carotid artery (ICA) dissection and to gain further insights into the mechanisms of cerebral ischemia.

Design  Patients with ICA dissection and ischemic stroke were identified by review of an angiographic database and hospital discharge codes. Patients were included if the diagnosis of ICA dissection was confirmed and diffusion-weighted imaging was obtained within 10 days of symptom onset. Infarct patterns were analyzed according to established templates of vascular territories.

Results  Inclusion criteria were met by 14 patients. Internal carotid artery occlusion was present in 10. Acute multiple brain infarction was found in 10 (71%) of the 14 patients. Cortical involvement was found in 8 patients, while the infarct was restricted to the subcortical region in 6. In 9 (64%) of the 14 patients, ischemic lesions were located in 1 of the 3 border zones.

Conclusions  Acute multiple brain infarction pattern with border zone involvement is frequently found in ICA dissection–related strokes. This finding may further support an interaction of hemodynamic and embolic mechanisms as a cause of cerebral ischemia in this condition.

From the Department of Neurology, University of Miami School of Medicine, Miami, Fla.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Diffusion-Weighted Imaging in Stroke Attributable to Internal Carotid Artery Dissection: The Significance of Vessel Patency
Bonati et al.
Stroke 2008;39:483-485.
ABSTRACT | FULL TEXT  

Antiplatelets Versus Anticoagulation in Cervical Artery Dissection
Engelter et al.
Stroke 2007;38:2605-2611.
ABSTRACT | FULL TEXT  

Diffusion-Weighted Magnetic Resonance Imaging in Symptomatic Vertebrobasilar Atherosclerosis and Dissection
Koch et al.
Arch Neurol 2005;62:1228-1231.
ABSTRACT | FULL TEXT  

Stroke Mechanisms in Acute Internal Carotid Artery Dissection
JWatch Neurology 2004;2004:2-2.
FULL TEXT