SEARCH · PubMed Health

Results for “Dissection”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,297 records · Page 72Linked to original sources

PubMed1994

[Indication for the lymph node dissection of gastric cancer based on the pattern analysis small of lymphatic spread].

A total of 8,230 cases of gastric cancer treated at CIH were subjected to the analysis of the pattern of lymphatic spread with an aim of getting indication for the lymph node dissection of Small gastric cancer. Modified dissection (D1-alpha) is indicated for the patients with following conditions: 1) every elevated or flat type mucosal cancer, 2) excavated (IIc) type mucosal cancer less than 10mm in diameter, 3) elevated or flat type submucosal cancer less than 10mm in diameter, 4) excavated submucosal cancer less than 5mm in diameter. Extended dissection (D2 + alpha) is indicated for small cancer which exposed to serosa. Cancer in the upper thirds needs total gastrectomy or cardiectomy according to the state of #5 and 6 nodes, with complete dissection of #1 to 11 nodes associated with sampling of #16 nodes. Total gastrectomy with complete dissection of #1 to 11 nodes and sampling of #16 nodes is indicated for the advanced small cancer in the middle thirds, and total gastrectomy with complete dissection of #1 to 13 nodes and sampling of #14, 16 nodes is indicated for cancer in the lower thirds.

Humans↗

PubMed1996

Axillary lymph node dissection: does it have a role in primary breast cancer?

The role of elective lymph node dissection has been increasingly questioned for the treatment of primary breast cancer. In an attempt to evaluate whether or not axillary lymph node dissection is of value in early breast cancer, a retrospective review of all breast cancers treated at Eisenhower Army Medical Center was conducted. During that time, 434 patients with breast cancer were treated. Eighty-six of those patients had lesions that were 2.0 cm or smaller. Eighty-one patients underwent axillary lymph node dissection. Twenty-four patients were found to have positive axillary nodes (28%). If the patients were further divided into those with lesions 1.0 centimeters or less versus 1.1-2.0 cm, the incidence of node positivity was 19 per cent and 35 per cent, respectively. Of the patients who underwent axillary lymph node dissection, 60 per cent of those whose lymph nodes were negative received no further treatment, whereas those whose lymph nodes were positive received additional therapy 92 per cent of the time. An additional 8 per cent of the node-negative patients received radiation therapy as the only added therapy after segmental mastectomy with axillary lymph node dissection. Our study demonstrates, or at least suggests, that node positivity did influence subsequent therapy. In addition, the relatively high incidence of positive axillary nodes (28%) in these early breast cancers supports the potential therapeutic benefit of axillary node dissection.

Axilla↗

PubMed1996

Is axillary lymph node dissection necessary in the routine management of breast cancer? Yes.

Axillary dissection for primary operable cancer follows the basic tenets of surgical oncology and achieves the stated goals. Local control is excellent, with failure rates of 0% to 2%. Long-term, disease-free survival is improved with axillary dissection. It is often stated that axillary dissection is not required for the smallest lesions, but the 15% risk of axillary disease with the T1A lesion suggests otherwise. Axillary sampling would not achieve the stated goals because of the high probability of retained, potentially resectable disease in the node-positive group. Axillary recurrence is associated with unacceptably high morbidity and mortality rates. Although the survival is similar in the three treatment groups of NSABP B-04, the inordinately high systemic failure rate with axillary recurrence would suggest that more aggressive local control could prevent many of these failures. After all, long-term survival free of disease is reported in many series, even in patients with multiple involved nodes. Axillary dissection also generates the most accurate prognostic variable on which further therapeutic interventions are predicated. At present, no other diagnostic or therapeutic approach achieves all these goals. The value of the axillary dissection is to provide accurate prognostic information, provide excellent local control, and improve the survival rate in the node-positive group. Perhaps in the future, a diagnostic test such as PET scanning or sentinel node mapping will identify patients with a clear axilla, who therefore do not require an axillary dissection. There has yet to be a primary operable carcinoma that benefits from preservation of potentially fully resectable disease.

Axilla↗

PubMed1996

[Value of radical lymph node dissection (compartment I and II) in stomach carcinoma].

In a prospective multicentre study of 2394 patients with gastric carcinoma the prognostic relevance of systematic lymph node dissection was evaluated. Of 1654 patients undergoing resection, 558 had a standard lymph node dissection, defined as fewer than 26 nodes in the specimen, and 1096 underwent radical lymphadenectomy, i.e. 26 or more nodes in the specimen. Radical dissection significantly improved the survival rate in patients with Union Internacional Contra la Cancrum (UICC) stages II and IIIA tumors. Multivariate analysis identified radical dissection as an independent prognostic factor in the subgroups of patients with UICC tumor stages II and IIIA. Radical dissection conferred no survival advantage in patients with pN2 tumors. There was no significant difference in morbidity and mortality rates between radical and standard lymph node dissection. Radical lymphadenectomy improves survival in patients with UICC gastric cancer stages II and IIIA, and should be the recommended treatment for such patients.

Adult↗

PubMed1997

[Investigation into mediastinal lymph node metastasis of lung cancer and rationale for decision of the extent of mediastinal dissection].

UNLABELLED: From the study on the regional lymphatic drainage and investigation into mediastinal lymph node metastasis of lung cancer, we have decided the extent of mediastinal dissection as follows; 1) For right lung cancer, as the routine procedure, extended systematic ipsilateral mediastinal dissection including the left tracheobronchial region, the anterior and the posterior ipsilateral mediastinum through a conventional thoracotomy. 2) For left lung cancer, as the routine procedure, systematic bilateral mediastinal dissection through a median sternotomy. 3) For the patients with advanced lymph node metastasis (the highest mediastinal or the cervical node involvement) or direct extension into the upper mediastinum of cancer in any side of the lungs, the lower half of modified radical neck dissection combined with systematic bilateral mediastinal dissection through a cervical collar incision and median sternotomy. RESULTS: 1. The noteworthy location and incidences of mediastinal lymph node involvement were as follows; 1) Among 34 patients of right lung cancer with pN2-3 M0 disease, in 5 patients the anterior mediastinal node involvement and in 6 patients (18%) the contralateral tracheobronchial node involvement were found by the pathological investigation at surgery. 2) The incidences of contralateral mediastinal node involvement at median sternotomies were 20% of 15 patients of the left upper lobe primary and 57% of 7 patients of the left lower lobe primary. 2. Postoperative survival rates calculated with Kaplan-Meier method; 1) The five-year survival rates were 67% in 22 patients with pT1-2N2M0; 72% in 20 patients with pT1-2N2-3 alpha (one level) M0 and 65% in 13 patients with pT1-2N2-3 alpha (multi level) M0. 2) The five-year survival rate of 8 patients with N3 gamma whose cancer were diagnosed as cN0-3 alpha preoperatively and resected completely was 60%. In conclusion, these results encourage us to continue this study because we can believe that our systematic mediastinal dissection beyond the anatomical difficulties would bring better prognoses in the patients with pN2-3 disease.

Humans↗

PubMed1997

[Spontaneous coronary dissection as a cause of acute myocardial infarct: description of a case and review of the literature].

Spontaneous coronary artery dissection is a rare cause of acute myocardial ischemia or death that is generally not detected until an autopsy is performed. It occurs in relatively young people and particularly in females. To date, its prognosis and treatment are not well defined. We describe our experience with one patient with acute myocardial infarction due to spontaneous dissection of the right coronary artery, which was treated successfully through direct coronary angioplasty. A 48-year-old man, heavy smoker, was admitted to our CCU for an acute inferior myocardial infarction with right ventricle involvement, which was complicated by the onset of cardiogenic shock (severe arterial hypotension, cold, pale and clammy skin, decrease in mental alertness, marked bradycardia due to a complete atrioventricular block). Since systemic thrombolysis was contraindicated (syncope followed by cranial trauma at the onset of symptoms), the patient underwent urgent coronary angiography that showed a proximal right coronary subocclusion with a filling defect and oblique linear density indicating possible dissection. Primary angioplasty was successfully attempted and a good distal flow was achieved (TIMI 3), but coronary artery dissection became more evident, with a double lumen extending over the distal segment just to the crux. Coronary stenting was not performed because optimum anticoagulant therapy was contra-indicated due to cranial trauma. Standard medical therapy was started after the procedure and coronary angiography, which was repeated before the patient was released from hospital, showed complete healing of the right coronary artery without any signs of dissection. The patient remained asymptomatic at a six-month follow-up check, with a negative exercise test. In our opinion, coronary angioplasty is a suitable therapeutic option in the treatment of spontaneous coronary dissection. More extensive experience is needed in order to standardize the most suitable therapeutic procedure in this rare cause of myocardial ischemia.

Angioplasty, Balloon↗

PubMedDate not supplied

Surgical treatment of dissecting aortic aneurysm. Twenty years' experience.

Early and late results of 40 cases of dissecting aortic aneurysm were reported. 1. Result of 6 cases with acute dissection was as follows: two of three surgical patients survived, whereas all three with drug therapy died. Surgical treatment is preferred for the dissection of the ascending aorta or the arch. Some problems of the postoperative morbidity were discussed: 2. Whether medically treated or surgically, chronic dissection of the descending aorta or the abdominal aorta had better prognosis than that of the other site. Chronic dissection with no saccular enlargement had good prognosis. More than 10 years survival is to be expected. The operative result for the chronic aortic dissection was poor, especially in case of the involved ascending aorta and arch. For the saccular enlargement of the pseudolumen wrapping method with or without the resection might be the preferable procedure to avoid early rupture.

Acute Disease↗

PubMed1999

A technique to visualize corneal incision and lamellar dissection depth during surgery.

PURPOSE: To describe a surgical technique to visualize the depth of corneal incisions and lamellar stromal dissections during surgery. METHODS: In porcine cadaver eyes, the aqueous was exchanged by air. Thus an air-to-endothelium interface (i.e., a useful optical surface) was created at the posterior corneal surface. The air-to-endothelium interface was used as a reference plane to visualize the corneal thickness and the relative depth of corneal incisions and dissections. Freehand peripheral corneal incisions, tangential keratotomy incisions, and lamellar stromal dissections were made at an intended corneal depth of 60, 80, and 99%. Light microscopy was used to measure the relative depth of the incisions and dissections. RESULTS: Achieved depth for peripheral corneal incisions averaged 65.2+/-5.3%, 78.8+/-5.1%, and 93.4+/-6.0%, respectively (p<0.05); and for tangential keratotomy incisions, 68.2+/-7.3%, 83.2+/-4.4%, and 95.8+/-3.6%, respectively (p<0.05). Achieved depth for lamellar stromal dissections averaged 58.3+/-9.4%, 81.1+/-3.4%, and 94.4+/-1.5%, respectively (p<0.05). Microperforations occurred with three incisions made at 99% intended depth. CONCLUSION: During surgery, the depth of incisions and lamellar dissections relative to the corneal thickness can be visualized by filling the anterior chamber with air (i.e., by creating an optical interface at the posterior corneal surface).

Air↗

PubMed2006

Echocardiographic findings mimicking type A aortic dissection.

BACKGROUND: Type A aortic dissection is a rare, but life-threatening disease. The prognosis is determined by an accurate and immediate diagnosis. CASE STUDY: A patient with suspected type A dissection based on outward transesophageal echocardiography (TEE) findings is reported. Renewed TEE showed dilation of the ascending aorta with pronounced wall thickness. A membrane-like structure was found in the ascending aorta. M-mode technique revealed movement of the suspected membrane that was partially in parallel to the aortic wall. Thus, there were severe doubts on the presence of type A dissection. By contrast, typical intimal rupture was found in the descending aorta. Computed tomography (CT) and angiography showed aortic dilation and an extended wall hematoma deriving from the entry at the descending part. There was no evidence of type A dissection. CONCLUSION: TEE is a noninvasive diagnostic tool to assess aortic dissection of type A with a sensitivity of 90-98% that is equal to CT or magnetic resonance imaging (MRI) solely. Complementary use of CT or MRI could improve the diagnostic accuracy. False-positive findings could result from echocardiographic artifacts concealing an intimal flap in the ascending aorta. Echo reverberations in dilated or calcified aortas had been judged to account for this phenomenon. In the present case, it could be assumed that the extended wall hematoma in accordance with vessel dilation mimicked the membrane-like structure. Oscillation or flutter of the suspicious intimal flap independently of aortal wall movement seem to be mandatory to avoid false-positive diagnoses. Ancillary findings such as flow signals, intimal fenestration or thrombosis are helpful to enhance the diagnostic specificity of TEE.

Aortic Dissection↗

PubMed2006

Carotid and vertebral artery dissections: clinical aspects, imaging features and endovascular treatment.

Extracranial arterial dissections are a recognised cause of stroke, particularly in young adults. Clinical diagnosis may be difficult, and the classical triad of symptoms is uncommon. Imaging plays a pivotal role in the diagnosis of extracranial arterial dissections, and this review provides a detailed discussion of the relative merits and limitations of currently available imaging modalities. Conventional arteriography has been the reference standard for demonstrating an intimal flap and double lumen, which are the hallmarks of a dissection, and for detecting complications such as stenosis, occlusion or pseudoaneurysm. Noninvasive vascular imaging methods, such as ultrasound (US), magnetic resonance angiography (MRA) and computed tomography angiography (CTA) are increasingly replacing conventional angiography for the diagnosis of carotid and vertebral dissections. Ultrasound provides dynamic and "real-time" information regarding blood flow. Source data of MRA and CTA and additional cross-sectional images can provide direct visualisation of the mural haematoma and information about the vessel lumen. Anticoagulation to prevent strokes is the mainstay of medical treatment, but randomised trials to define the optimal treatment regime are lacking. Surgery has a limited role in management of dissections, but endovascular procedures are gaining importance for treatment of complications and if medical management fails.

Carotid Artery, Internal, Dissection↗

PubMed2002

Vertigo and cranial nerve palsy caused by different forms of spontaneous dissections of internal and vertebral arteries.

In this report we compare a subintimal hemorrhage of a dissected vertebral artery to a subadventitial hemorrhage of a dissected extracranial internal carotid artery. A subintimal hemorrhage compresses the lumen of the artery. Therefore, magnetic resonance imaging (MRI), angiography and ultrasound are screening methods. For the subadventitial hemorrhage, which does not really compress the lumen but forms an aneurysmal dilatation, MRI is the only method of choice. We describe a case in which vertigo, nausea and vomiting are the only symptoms of a subintimal vertebral artery dissection. In this case an infarction of the cerebellar region supplied by the superior cerebellar artery could be demonstrated. Our second case demonstrates a palsy of the 10th, 11th and 12th cranial nerves, which is a less frequent symptom of internal artery dissections. The palsy of these cranial nerves seems to be caused by compression of the nerves or their nutritional arteries close to the aneurysmal dilatation of the subadventitial dissected internal carotid artery. In both cases clinical symptoms were resolved after anticoagulation.

Adult↗

PubMed2000

Three-dimensional computed tomographic angiography in four patients with dissecting aneurysms of the vertebrobasilar system.

BACKGROUND: Recently, three-dimensional computed tomographic angiography (CTA) has been used for the diagnosis and treatment planning of cerebral aneurysm presenting with or without subarachnoid haemorrhage, but the diagnostic value of CTA has not been established. This study evaluated the usefulness of CTA in patients with dissecting aneurysms of the vertebrobasilar system. METHOD: Four patients with acute dissecting aneurysms were examined by CTA, including 3 women and 1 man with a mean age of 60.5 +/- 8.5 years (range: 52-67 years). There were three patients with subarachnoid haemorrhage and one patient presenting with ischaemia. One patient underwent CTA twice and digital subtraction angiography (DSA) once, while one patient had both examinations three times. CTA was performed with a nonionic contrast medium (100 ml of iomeprol 350 mg I/ml) administered via an auto-injector into an antecubital vein at 1.5-1.7 ml/s. To reconstruct three-dimensional images, the volume rendering method was utilized. FINDINGS: All initial CTA studies were performed safely within 5 hours after onset. In patients with subarachnoid haemorrhage, all lesions were demonstrated by finding either the "pearl and string sign" or a "double shadow" on CTA. In the patient presenting with ischaemia, "pearl and string sign" and "double shadow" was shown after the second CTA, and follow-up CTA was able to demonstrate the change of the lesion morphology. All lesions had more irregular luminal surfaces than the non-lesional segments of the involved vessels. INTERPRETATION: CTA was safe in patients with acute vertebrobasilar dissection and demonstrated either the "pearl and string sign" or a "double shadow" which were commonly showed on DSA. An "irregular luminal surface sign" on CTA seems to be one of the characteristics of vertebrobasilar dissection. The view shown by CTA is not less useful than that by DSA to diagnosis and treatment planning in the acute phase of vertebrobasilar dissection, and can also be employed to follow the changes of lesion morphology over time.

Aged↗

PubMed1964

HISTOLOGY OF THE AORTIC MEDIA IN DISSECTING ANEURYSMS.

Sections of the ascending aorta of 27 cases of dissecting aneurysm were compared histologically with the ascending aortae of 27 age- and sex-matched normotensive controls and 27 age- and sex-matched hypertensive controls. Elastic fragmentation and loss was seen to a similar degree in each series. Strip-like areas of muscle necrosis appeared to be associated as much with hypertension as with dissection. Two cases of dissecting aneurysm showed giant-cell aortitis. Mucopolysaccharide ;cysts' were seen more frequently, but by no means invariably, in the dissecting series. The only abnormality that distinguished the dissecting aortae from the normotensive and hypertensive controls with any constancy was an increase in the degree of metachromasia of the ground substance.

Aged↗

PubMed2006

Pain as the only symptom of cervical artery dissection.

BACKGROUND: Headache or neck pain is a frequent symptom of spontaneous cervical artery dissection (sCAD). PATIENTS AND METHODS: Patients were drawn from an ongoing hospital-based registry of consecutive cases diagnosed with sCAD. Only patients with isolated pain were included in this series. Pain topography, dynamics, severity and quality, imaging findings and outcome were analysed. RESULTS: 20 of 245 (8%) patients with sCAD presented with pain as the only symptom (mean (SD) age 39 (8) years; 14 (70%) women). Of them, 12 had vertebral artery dissection, 3 had internal carotid dissection and 5 had multiple dissections. The median delay from symptom onset to diagnosis was 7 days (range 4 h to 29 days). 6 patients presented with headache, 2 with neck pain and 12 with both. Onset of headache was progressive in 6, acute in 8 and thunderclap-type in 4 patients; neck pain was progressive in 7 and acute in 7. Headache was throbbing in 13 and constrictive in 5 patients; neck pain was throbbing in 4 and constrictive in 10. Pain was unilateral in 11 and bilateral in 9. Pain was different from earlier episodes in all but one case. All patients were pain free at 3 months. CONCLUSION: Pain may be the only symptom in sCAD, even when multiple arteries are dissected. Pain topography, dynamics, quality and intensity were heterogeneous. Data from this study lend support to recommendations favouring imaging studies of the cervical arteries in patients with new-onset unexplained headache or neck pain.

Adult↗

PubMed2004

Gender-related differences in acute aortic dissection.

BACKGROUND: Few data exist on gender-related differences in clinical presentation, diagnostic findings, management, and outcomes in acute aortic dissection (AAD). METHODS AND RESULTS: Accordingly, we evaluated 1078 patients enrolled in the International Registry of Acute Aortic Dissection (IRAD) to assess differences in clinical features, management, and in-hospital outcomes between men and women. Of the patients enrolled in IRAD (32.1%) with AAD, 346 were women. Although less frequently affected by AAD (32.1% of AAD), women were significantly older and had more often presented later than men (P=0.008); symptoms of coma/altered mental status were more common, whereas pulse deficit was less common. Diagnostic imaging suggestive of rupture, ie, periaortic hematoma, and pleural or pericardial effusion were more commonly observed in women. In-hospital complications of hypotension and tamponade occurred with greater frequency in women, resulting in higher in-hospital mortality compared with men. After adjustment for age and hypertension, women with aortic dissection die more frequently than men (OR, 1.4, P=0.04), predominantly in the 66- to 75-year age group. Moreover, surgical outcome was worse in women than men (P=0.013); type A dissection in women was associated with a higher surgical mortality of 32% versus 22% in men despite similar delay, surgical technique, and hemodynamics. CONCLUSIONS: Our analysis provides insights into gender-related differences in AAD with regard to clinical characteristics, management, and outcomes; important diagnostic and therapeutic implications may help shed light on aortic dissection in women to improve their outcomes.

Acute Disease↗

PubMed2003

Cervical arterial dissection: time for a therapeutic trial?

BACKGROUND AND PURPOSE: Cervical arterial dissection is a major cause of stroke in young adults, yet despite standard treatment with anticoagulants or antiplatelet drugs, its management remains uncertain. The goal of this study was to assess the natural history of the disorder and to decide on the feasibility of a therapeutic trial. METHODS: Collaborating members of the Canadian Stroke Consortium prospectively enrolled consecutively referred patients with angiographically proven acute vertebral or carotid arterial dissection. Data recorded included clinical and radiological details, recurrence of ischemic cerebral events, and medical or surgical treatment. RESULTS: Of 116 patients, 67 had vertebral and 49 had carotid dissections, with no difference in age or sex. In 68 (59%), trauma occurred at the time of dissection. During the course of a 1-year follow-up, at least 17 patients (15%) had recurrent transient ischemic attacks, stroke, or death, mainly in the weeks immediately after the dissection. In 105 patients with complete follow-up, the event rate in those treated with anticoagulants was 8.3% and in those treated with aspirin was 12.4%, a nonsignificant difference of 4.1%. Using these data, we calculate that for a 2-arm trial (aspirin versus anticoagulants) with 80% power and 5% significance, 913 patients are needed in each group. CONCLUSIONS: From our data indicating an initial relatively high recurrence rate, a multicenter trial of anticoagulants versus aspirin involving a total of 2000 patients is feasible.

Adult↗

PubMed2002

Predicting death in patients with acute type a aortic dissection.

BACKGROUND: Given the high mortality rates in patients with type A aortic dissection, predictive tools to identify patients at increased risk of death are needed to assist clinicians for optimal treatment. METHODS AND RESULTS: Accordingly, we evaluated 547 patients with this diagnosis enrolled in the International Registry of Acute Aortic Dissection (IRAD) between January 1996 and December 1999. Univariate testing followed by multivariate logistic regression analysis was performed to identify independent predictors of death. In-hospital mortality rate was 32.5% in type A dissection patients. In-hospital complications (neurological deficits, altered mental status, myocardial or mesenteric ischemia, kidney failure, hypotension, cardiac tamponade, and limb ischemia) were increased in patients who died compared with survivors (P<0.05 for all). Logistic regression identified the following presenting variables as predictors of death: age > or =70 years (OR, 1.70; 95% CI, 1.05 to 2.77; P=0.03), abrupt onset of chest pain (OR 2.60; 95% CI, 1.22 to 5.54; P=0.01), hypotension/shock/tamponade (OR, 2.97; 95% CI, 1.83 to 4.81; P<0.0001), kidney failure (OR, 4.77; 95% CI, 1.80 to 12.6; P=0.002), pulse deficit (OR, 2.03; 95% CI, 1.25 to 3.29, P=0.004), and abnormal ECG (OR, 1.77; 95% CI, 1.06 to 2.95; P=0.03) (area under receiver operating curve, 0.74; Hosmer-Lemeshow statistic, P=0.75). CONCLUSIONS: The in-hospital mortality rate in acute type A aortic dissection is high and can be predicted with the use of a clinical model incorporated in a simple risk prediction tool. This tool can be used to educate patients with dissection about their predicted risk and in clinical research for risk adjustment while comparing outcomes of different therapies.

Aged↗

PubMed2004

[Spontaneous cervical carotid and vertebral arteries dissection: study of 48 patients].

OBJECTIVE: To report a Brazilian series of spontaneous cervical arterial dissections, risk factors, warning symptoms, clinical manifestations, diagnostic tests, treatment and prognosis. METHOD: We performed the retrospective analysis of clinical and neuroradiological records (MRI, A-MRI and Angiography) of patients with this diagnosis who were evaluated in a tertiary hospital for the period of 1997-2003. RESULTS: 48 patients (24 men) with median age 37.9 years: 26 patients with unilateral internal carotid dissection (ICAD), 15 with unilateral vertebral artery dissection (VAD) and 7 with multivessel dissections. All patients presented neurological deficits. Hypertension, smoking and dyslipidemia were the main risk factors. More than 80% of patients presented at least one initial symptom, most of them temporoparietal headache. 44% of patients with VAD and only 3.4% of patients with ICAD had neck pain. The median interval between the onset of symptom and the appearance of neurological deficit was 5.4 days for ICAD and 13.5 days for VAD. Five patients with ICAD presented preceding TIA. Angiography was performed in 93% of patients. In 42% of these patients, MRI and A-MRI were associated. In three patients the diagnosis was made just through cervical MRI. 75% of patients received anticoagulation. Two patients received intravenous thrombolytic therapy with no complications. Prognosis was good for all patients but two patients with bilateral ICAD died. CONCLUSION: Our results are similar to the literature, except for the low frequency of neck pain in ICAD patients and predominance of temporoparietal headache in cervical artery dissection patients. Vascular risk factors were commonly found.

Adolescent↗