Carotid Artery Dissections

The echocolor Doppler is an excellent tool in screening for carotid dissection defined as the splitting of the arterial wall of the carotid artery.

Carotid artery dissection is associated with hematoma in the wall of the artery. The intramural hematoma can expand towards the intima (resulting in a stenosis of the artery), or the adventitia (resulting in an aneurismal dilatation of the artery).

In the internal carotid artery (ICA) dissection, the main ultrasound findings are:

a) an arterial luminal flap or false lumen (the most specific sign);

b) bulbar and/or proximal ICA hematoma or low-reflective thrombus with or without narrowed true lumen;

c) bulb and origin of ICA with high resistance flow pattern to a stenotic hematoma in the cervical ICA segment not explored directly with the ultrasound ("indirect" sign).

In this lesson the echocolor Doppler findings of the carotid artery dissections will be presented.

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