J Korean Soc Emerg Med.  2006 Dec;17(6):615-622.

Usefulness of Multidetector Computed Tomography Angiography in Vertebral and Basilar Artery Dissection

• Jeon WC
• Min YG
• Bae YS
• Lee KJ

Abstract

PURPOSE: Vertebral and basilar artery dissection (VBAD) is difficult to diagnose by conventional computed tomography. However, Multi-detector computed tomography (MDCT) angiography is not only a less invasive diagnostic technique than conventional angiography but also provides high quality images. We assessed clinical manifestations and usefulness of MDCT angiography in VBAD.
METHODS
We retrospectively reviewed clinical manifestations, magnetic resonance angiography (MRA) and MDCT angiographic findings of 29 patients who were diagnosed with VBAD by conventional angiography from January 2001 to December 2004. A radiologist reviewed MRA, MDCT axial source images, and three dimensional angiography.
RESULTS
The mean patient age was 45.9+/-10.2 years. and 23 (79.3%) patients were less than 55 years old. Eight patients had precipitating factors such as trauma, hyperextension and sports activity. Nineteen patients out of 29 presented with neurological symptoms such as sensory change, dysarthria, ataxia and cerebellar dysfunction. The remaining 10 patients exhibited only nonspecific symptoms such as headache, neck pain and dizziness. Among 19 VBAD patients tested by MRA, 13 patients had positive radiological findings. and 16 of 17 patients evaluated MDCT angiography had positive radiological findings. Therefore, the sensitivities of MRA and MDCT angiography in diagnosing VBAD were 68.4% and 94.1%, respectively.
CONCLUSION
VBAD is a cause of stroke at young age. The patients with VBAD may have precipitating factors and can present with nonspecific symptoms without any neurological deficit. MDCT angiography is suitable for use as a rapid diagnostic tool for VBAD.

Keyword

Vertebral artery dissection; Basilar artery; Angiography; Magnetic resonance angiography; Spiral computed tomography

MeSH Terms

Angiography*
Ataxia
Basilar Artery*
Cerebellar Diseases
Dizziness
Dysarthria
Headache
Humans
Magnetic Resonance Angiography
Middle Aged
Multidetector Computed Tomography*
Neck Pain
Precipitating Factors
Retrospective Studies
Sports
Stroke
Tomography, Spiral Computed
Vertebral Artery Dissection