Details

Autor(en) / Beteiligte

• Nistri, M
• Perrini, P
• Di Lorenzo, N
• Cellerini, M
• Villari, N
• Mascalchi, M

Titel

Third-nerve palsy heralding dissecting aneurysm of posterior cerebral artery: digital subtraction angiography and magnetic resonance appearance

Ist Teil von

• Journal of neurology, neurosurgery and psychiatry, 2007-02, Vol.78 (2), p.197-198

Ort / Verlag

England: BMJ Publishing Group Ltd

Erscheinungsjahr

2007

Quelle

BMJ Journals Archiv - DFG Nationallizenzen

Beschreibungen/Notizen

• Twenty days later, axial fluid-attenuated inversion recovery magnetic resonance (FLAIR MR) image (C) and axial T1-weighted source image of three-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA) (D) show an area of abnormal signal intensity in the right portion of the ambiens cistern surrounding the P1-P2 segment of the right PCA, consistent with intramural haematoma in the subacute phase. SAHs are not rare in intracranial artery dissections because they lack an external elastic membrane and have a thinner adventitia and fewer elastic fibres in the media as compared with extracranial vertebral and carotid arteries. 2, 3 Diagnosis of intracranial artery dissection relies on DSA, but MRI and MRA have found a role in establishing the initial diagnosis and in the follow-up. 1, 2, 4 DSA signs of arterial dissections include irregular narrowing ("pearl and string sign"), fusiform aneurysm ("pseudoaneurysm" or dissecting aneurysm) and venous mural pooling of contrast medium, although the only pathognomonic DSA finding is the identification of a double lumen-that is, the passage of the contrast medium into a true and false lumen. 2, 3 MRI is an ideal complement to DSA, as it can directly enable assessment of the vessel wall and demonstration of the intramural haematoma.