Abstract
Recently, intracranial arterial dissection has recently been considered to be one of the main causes of brain infarction in young adults. Intracranial arterial dissection, excepting the vertebrobasilar, artery is still rare and its natural history remains unclear. We retrospectively analyzed the clinical manifestations, serial radiological changes, treatments, and outcomes in patients with non-hemorrhagic intracranial arterial dissection, excepting the vertebrobasilar artery. Patients were 6 males and 3 females, and the mean age was 53.1 years. Six of the 9 patients (67%) presented with hemiparesis, 2 (22%) with headache, 1 (11%) with sensory disturbance, and 1 (11%) with dizziness. NIHSS on admission were 0-10. The site of the dissection involved 1 internal carotid artery (C4 portion), 3 anterior cerebral arteries (A2 portion), 2 middle cerebral arteries M1 portion, 1 middle cerebral artery M2 portion, and 2 posterior cerebral arteries (P2 portion). Initial angiography or MR angiography revealed string sign in 7 (78%) and pearl and string sign in 2 (22 %) of the patients. Serial angiographic changes were observed in 7 patients. Four regressions, 3 progressions, and 2 stables were detected. Regression after progression was observed in 2 cases and progression after regression was observed in 1 patient. Six out of 9 patients underwent anti-thrombotic therapy in the acute stage, and all patients received an anti-platelet agent as chronic stage treatment. Modified Rankin Scales at 3 months after onset were 0-2. Our results suggest that anti-thrombotic therapy in patients with non-hemorrhagic arterial dissection results in good clinical outcome, however, the indication and selection of anti-thrombotic therapy should be considered carefully in order to avoid hemorrhagic complications.
