Diagnostic imaging in carotid artery dissection: a case report and review of current modalities

Ann Vasc Surg. 2014 Apr;28(3):739.e5-9. doi: 10.1016/j.avsg.2013.02.031. Epub 2014 Feb 1.

Abstract

Background: This case report presents the challenges associated with the existing screening modalities in the diagnosis of carotid artery dissection, and also reviews the diagnostic efficiency, limitations, and recent advances in imaging technology.

Case presentation: A 54-year-old man with blunt trauma and subsequent development of ischemic stroke and no clear initial evidence of carotid dissection with noninvasive screening, including magnetic resonance imaging, magnetic resonance angiography, and computed tomography angiography.

Conclusions: Despite emerging noninvasive imaging techniques, conventional angiography should still be considered to establish a diagnosis of carotid artery dissection, particularly when other imaging modalities are negative or inconclusive but a high degree of clinical suspicion exists based on symptoms or mechanism of injury.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Angiography, Digital Subtraction
  • Aortic Dissection / diagnosis*
  • Aortic Dissection / etiology
  • Aortic Dissection / therapy
  • Brain Ischemia / diagnosis
  • Brain Ischemia / etiology
  • Carotid Artery Injuries / diagnosis*
  • Carotid Artery Injuries / etiology
  • Carotid Artery Injuries / therapy
  • Carotid Artery, Internal* / diagnostic imaging
  • Carotid Artery, Internal* / pathology
  • Diffusion Magnetic Resonance Imaging
  • Humans
  • Magnetic Resonance Angiography
  • Male
  • Middle Aged
  • Multimodal Imaging* / methods
  • Predictive Value of Tests
  • Stroke / diagnosis
  • Stroke / etiology
  • Tomography, X-Ray Computed