Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection

Debette, S., Compter, A., Labeyrie, M-A., Uyttenboogaart, M., Metso, T. M., Majersik, J. J., Goeggel-Simonetti, B., Engelter, S. T., Pezzini, A., Bijlenga, P., Southerland, A. M., Naggara, O., Bejot, Y., Cole, J. W., Ducros, A., Giacalone, G., Schilling, S., Reiner, P., Sarikaya, H., Welleweerd, J. C., Kappelle, L. J., de Borst, G. J., Bonati, L. H., Jung, S., Thijs, V., Martin, J. J., Brandt, T., Grand-Ginsbach, C., Kloss, M., Mizutani, T., Minematsu, K., Meschia, J. F., Pereira, V. M., Bersano, A., Touze, E., Lyrer, P. A., Leys, D., Chabriat, H., Markus, H. S., Worrall, B. B., Chabrier, S., Baumgartner, R., Stapf, C., Tatlisumak, T., Arnold, M. & Bousser, M-G., Jun-2015, In : Lancet Neurology. 14, 6, p. 640-654 15 p.

Research output: Contribution to journalReview articleAcademicpeer-review

  • Stephanie Debette
  • Annette Compter
  • Marc-Antoine Labeyrie
  • Maarten Uyttenboogaart
  • Tina M. Metso
  • Jennifer J. Majersik
  • Barbara Goeggel-Simonetti
  • Stefan T. Engelter
  • Alessandro Pezzini
  • Philippe Bijlenga
  • Andrew M. Southerland
  • Olivier Naggara
  • Yannick Bejot
  • John W. Cole
  • Anne Ducros
  • Giacomo Giacalone
  • Sabrina Schilling
  • Peggy Reiner
  • Hakan Sarikaya
  • Janna C. Welleweerd
  • L. Jaap Kappelle
  • Gert Jan de Borst
  • Leo H. Bonati
  • Simon Jung
  • Vincent Thijs
  • Juan J. Martin
  • Tobias Brandt
  • Caspar Grand-Ginsbach
  • Manja Kloss
  • Tohru Mizutani
  • Kazuo Minematsu
  • James F. Meschia
  • Vitor M. Pereira
  • Anna Bersano
  • Emmanuel Touze
  • Philippe A. Lyrer
  • Didier Leys
  • Hugues Chabriat
  • Hugh S. Markus
  • Bradford B. Worrall
  • Stephane Chabrier
  • Ralph Baumgartner
  • Christian Stapf
  • Turgut Tatlisumak
  • Marcel Arnold
  • Marie-Germaine Bousser

Spontaneous intracranial artery dissection is an uncommon and probably underdiagnosed cause of stroke that is defined by the occurrence of a haematoma in the wall of an intracranial artery. Patients can present with headache, ischaemic stroke, subarachnoid haemorrhage, or symptoms associated with mass effect, mostly on the brainstem. Although intracranial artery dissection is less common than cervical artery dissection in adults of European ethnic origin, intracranial artery dissection is reportedly more common in children and in Asian populations. Risk factors and mechanisms are poorly understood, and diagnosis is challenging because characteristic imaging features can be difficult to detect in view of the small size of intracranial arteries. Therefore, multimodal follow-up imaging is often needed to confirm the diagnosis. Treatment of intracranial artery dissections is empirical in the absence of data from randomised controlled trials. Most patients with subarachnoid haemorrhage undergo surgical or endovascular treatment to prevent rebleeding, whereas patients with intracranial artery dissection and cerebral ischaemia are treated with antithrombotics. Prognosis seems worse in patients with subarachnoid haemorrhage than in those without.

Original languageEnglish
Pages (from-to)640-654
Number of pages15
JournalLancet Neurology
Issue number6
Publication statusPublished - Jun-2015



ID: 19711388