Craniocervical arterial dissections with cerebral infarction: a five-case series with diagnostic application of vessel wall MRI
Abstract
Craniocervical arterial dissection (CCAD) is an important but often underdiagnosed cause of ischemic stroke, especially in young and middle-aged adults. We present a series of 5 patients (three men and 2 women, aged 25–45 years) with acute ischemic stroke secondary to CCAD, including 2 internal carotid artery dissections and 3 vertebral artery dissections. Initial computed tomography (CT) and CT angiography were inconclusive, while high-resolution vessel wall MRI (VW-MRI) revealed characteristic features such as intramural hematoma, intimal flap, double lumen, and mural enhancement. All patients were treated with aspirin monotherapy and demonstrated favorable outcomes without recurrence during short-term follow-up. This series highlights the diagnostic value of VW-MRI in patients with cryptogenic stroke and inconclusive CTA, underscoring its role in timely diagnosis and management of CCAD.
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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