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. 1985 Feb;48(2):111–121. doi: 10.1136/jnnp.48.2.111

Fatal intracranial arterial dissection: clinical pathological correlation.

M A Farrell, J J Gilbert, J C Kaufmann
PMCID: PMC1028209  PMID: 3981168

Abstract

The clinical pathological features of fatal arterial dissection confined to the intracranial vessels are described. Three patients with anterior circulation dissections presented with focal ischaemic neurological deficits and pathological examination of involved vessels revealed a dissection plane between internal elastic lamina and media accompanied by intravascular thrombosis. Three of four patients with posterior circulation dissections had clinical pathological features of subarachnoid haemorrhage and at necropsy had transmural dissections. In contrast to previous reports, primary vasculopathies either degenerative or inflammatory were not identified in affected vessels. The pathogenesis of intracranial arterial dissection is discussed and the clinical features are correlated with the pathological abnormalities.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adams H. P., Jr, Aschenbrener C. A., Kassell N. F., Ansbacher L., Cornell S. H. Intracranial hemorrhage produced by spontaneous dissecting intracranial aneurysm. Arch Neurol. 1982 Dec;39(12):773–776. doi: 10.1001/archneur.1982.00510240035009. [DOI] [PubMed] [Google Scholar]
  2. Adelman L. S., Doe F. D., Sarnat H. B. Bilateral dissecting aneurysms of the internal carotid arteries. Acta Neuropathol. 1974;29(2):93–97. doi: 10.1007/BF00684768. [DOI] [PubMed] [Google Scholar]
  3. Alexander C. B., Burger P. C., Goree J. A. Dissecting aneurysms of the basilar artery in 2 patients. Stroke. 1979 May-Jun;10(3):294–299. doi: 10.1161/01.str.10.3.294. [DOI] [PubMed] [Google Scholar]
  4. Berkovic S. F., Spokes R. L., Anderson R. M., Bladin P. F. Basilar artery dissection. J Neurol Neurosurg Psychiatry. 1983 Feb;46(2):126–129. doi: 10.1136/jnnp.46.2.126. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Campbell G. J., Roach M. R. Fenestrations in the internal elastic lamina at bifurcations of human cerebral arteries. Stroke. 1981 Jul-Aug;12(4):489–496. doi: 10.1161/01.str.12.4.489. [DOI] [PubMed] [Google Scholar]
  6. Chang V., Rewcastle N. B., Harwood-Nash D. C., Norman M. G. Bilateral dissecting aneurysms of the intracranial internal carotid arteries in an 8-year-old boy. Neurology. 1975 Jun;25(6):573–579. doi: 10.1212/wnl.25.6.573. [DOI] [PubMed] [Google Scholar]
  7. Escourolle R., Gautier J. C., Rosa A., Der Agopian P., Lhermitte F. Anévrysme disséquant vertébro-basilaire. Rev Neurol (Paris) 1973 Feb;128(2):95–104. [PubMed] [Google Scholar]
  8. Fisher C. M., Ojemann R. G., Roberson G. H. Spontaneous dissection of cervico-cerebral arteries. Can J Neurol Sci. 1978 Feb;5(1):9–19. [PubMed] [Google Scholar]
  9. Gagne F., Lemay M., Verret S. Hémodissection pariétale oblitérante des vaisseaux intracrâniens, une forme particulière d'anévrysme disséquant. Can J Neurol Sci. 1977 Feb;4(1):63–65. [PubMed] [Google Scholar]
  10. Harland W. A., Pitts J. F., Watson A. A. Subarachnoid haemorrhage due to upper cervical trauma. J Clin Pathol. 1983 Dec;36(12):1335–1341. doi: 10.1136/jcp.36.12.1335. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hayman J. A., Anderson R. M. Dissecting aneurysm of the basilar artery. Med J Aust. 1966 Aug 20;2(8):360–361. [PubMed] [Google Scholar]
  12. Hochberg F. H., Bean C., Fisher C. M., Roberson G. H. Stroke in a 15-year-old girl secondary to terminal carotid dissection. Neurology. 1975 Aug;25(8):725–729. doi: 10.1212/wnl.25.8.725. [DOI] [PubMed] [Google Scholar]
  13. Kunze S., Schiefer W. Angiographic demonstration of a dissecting aneurysm of the middle cerebral artery. Neuroradiology. 1971 Sep;2(4):201–206. doi: 10.1007/BF00337567. [DOI] [PubMed] [Google Scholar]
  14. Manz H. J., Vester J., Lavenstein B. Dissecting aneurysm of cerebral arteries in childhood and adolescence. Case report and literature review of 20 cases. Virchows Arch A Pathol Anat Histol. 1979 Oct;384(3):325–335. doi: 10.1007/BF00428233. [DOI] [PubMed] [Google Scholar]
  15. Mizutani T., Goldberg H. I., Parr J., Harper C., Thompson C. J. Cerebral dissecting aneurysm and intimal fibroelastic thickening of cerebral arteries. Case report. J Neurosurg. 1982 Apr;56(4):571–576. doi: 10.3171/jns.1982.56.4.0571. [DOI] [PubMed] [Google Scholar]
  16. Motulsky A. G. Sounding board. Biased ascertainment and the natural history of diseases. N Engl J Med. 1978 May 25;298(21):1196–1197. doi: 10.1056/NEJM197805252982111. [DOI] [PubMed] [Google Scholar]
  17. NEDWICH A., HAFT H., TELLEM M., KAUFFMAN L. DISSECTING ANEURYSM OF CEREBRAL ARTERIES. REVIEW OF THE LITERATURE AND REPORT OF A CASE. Arch Neurol. 1963 Nov;9:477–484. doi: 10.1001/archneur.1963.00460110045005. [DOI] [PubMed] [Google Scholar]
  18. Nass R., Hays A., Chutorian A. Intracranial dissecting aneurysms in childhood. Stroke. 1982 Mar-Apr;13(2):204–207. doi: 10.1161/01.str.13.2.204. [DOI] [PubMed] [Google Scholar]
  19. Pasquier B., N'Golet A., Pasquier D., Panh M. H., Couderc P., Crouzet G. Hémodissection vertébro-basilaire : une observation anatomo-clinique avec fibrodysplasie de l'artère vertébrale gauche. Sem Hop. 1979 Mar 8;55(9-10):487–488. [PubMed] [Google Scholar]
  20. Pikula B., Plamenac P., Ferkovic M. Anévrisme disséquant (hématome disséquant) d'une artère cérébrale après un effort physique intense. Rev Neurol (Paris) 1973 Feb;128(2):125–130. [PubMed] [Google Scholar]
  21. Pilz P., Hartjes H. J. Fibromuscular dysplasia and multiple dissecting aneurysms of intracranial arteries. A further cause of Moyamoya syndrome. Stroke. 1976 Jul-Aug;7(4):393–398. doi: 10.1161/01.str.7.4.393. [DOI] [PubMed] [Google Scholar]
  22. Senter H. J., Sarwar M. Nontraumatic dissecting aneurysm of the vertebral artery. Case report. J Neurosurg. 1982 Jan;56(1):128–130. doi: 10.3171/jns.1982.56.1.0128. [DOI] [PubMed] [Google Scholar]
  23. WOLMAN L. Cerebral dissecting aneurysms. Brain. 1959 Jun;82:276–291. doi: 10.1093/brain/82.2.276. [DOI] [PubMed] [Google Scholar]
  24. Yamashita M., Tanaka K., Matsuo T., Yokoyama K., Fujii T., Sakamoto H. Cerebral dissecting aneurysms in patients with moyamoya disease. Report of two cases. J Neurosurg. 1983 Jan;58(1):120–125. doi: 10.3171/jns.1983.58.1.0120. [DOI] [PubMed] [Google Scholar]
  25. Yonas H., Agamanolis D., Takaoka Y., White R. J. Dissecting intracranial aneurysms. Surg Neurol. 1977 Dec;8(6):407–415. [PubMed] [Google Scholar]
  26. Yuasa H., Tokito S., Izumi K., Hirabayashi K. Cerebrovascular moyamoya disease associated with an intracranial pseudoaneurysm. Case report. J Neurosurg. 1982 Jan;56(1):131–134. doi: 10.3171/jns.1982.56.1.0131. [DOI] [PubMed] [Google Scholar]

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