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Clin Neurol Neurosurg ; 190: 105653, 2020 03.
Article in English | MEDLINE | ID: mdl-31901612

ABSTRACT

Intracranial artery dissection (IAD) is an underdiagnosed, non-atherosclerotic cause of stroke with various clinical manifestations. To identify all the potential studies investigating the epidemiology, risk factors, symptoms, radiology findings, and treatment methods of IAD, we conducted a literature search screening PubMed, SCOPUS, EMBASE, and BIREME. According to the results of several studies, IAD is the major cause of ischemic stroke in at least one-third of the cervical-cranial artery dissection (CCAD) cases presenting with ischemic stroke. Mechanical causes are associated with cervical artery dissections (CAD) in up to 40 % of the cases. However, the risk factors for IAD are still not completely understood. Antithrombotic therapy with either antiplatelet or classic anticoagulants is the mainstay of treatment for preventing further thromboembolic complication after a stroke. Endovascular or surgical treatment options can be considered when medical therapies are not effective or when there is a high rate of recurrence or increased risk of bleeding. The observational studies have shown that these methods are very effective in preventing recurrence and significantly improving morbidity and mortality in patients with ruptured dissections. Clinical trials are required to establish the best option for each mechanism of ischemic lesion.


Subject(s)
Anticoagulants/therapeutic use , Aortic Dissection/epidemiology , Carotid Artery, Internal, Dissection/epidemiology , Endovascular Procedures , Ischemic Stroke/etiology , Middle Cerebral Artery , Platelet Aggregation Inhibitors/therapeutic use , Aortic Dissection/complications , Aortic Dissection/diagnostic imaging , Aortic Dissection/therapy , Carotid Artery, Internal, Dissection/complications , Carotid Artery, Internal, Dissection/diagnostic imaging , Carotid Artery, Internal, Dissection/therapy , Connective Tissue Diseases/epidemiology , Constriction, Pathologic , Humans , Hypertension/epidemiology , Intracranial Arterial Diseases/diagnosis , Intracranial Arterial Diseases/epidemiology , Intracranial Arterial Diseases/therapy , Migraine Disorders/epidemiology , Risk Factors
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