Cervical artery dissection (CAD) should be differentiated from cardioembolism, atherosclerosis, radiation treatment, vasculitis, fibromuscular dysplasia, dysgenesis of the internal carotid artery. The echocolor Doppler findings in some cases may be similar.
The clinic is very important for the differential diagnosis: it is necessary to keep in mind that CAD is a common cause of stroke in young and middle-aged patients and pain is usually the initial manifestation (the characteristic unilateral headache develops in 2/3 of patients).
In particular, in case of echocolor Doppler "stump flow" in the proximal ICA (dissection non-specific sign), the presence of laterocervical sudden pain, or headache, persistent and the absence of carotid atherosclerotic disease (CAD is a common cause of stroke in young, non atherosclerotic patients) are very useful for the differential diagnosis between dissection and obstruction of the distal ICA to other causes (cardioembolism or atherosclerotic occlusion of the distal cervical ICA).
In this lesson the echocolor Doppler differential diagnosis of the cervical arterial dissections are presented.
Franco Accorsi, MD
Member of the Order of Physician of Bologna n° 6728
I am a specialist in Medical Angiology and I am based in Bologna, Italy. Until 2008 (voluntary resignation) I worked at Maggiore Hospital in Bologna as "Dirigente Medico" in the Department of Internal Medicine and as Angiologist in the Angiology Unit with a position of "Alta Professionalità" in "Vascular Ecography and Angiology".
I am currently working in Bologna as an independent professional in the areas of angiology and vascular diagnostics.
I have been a speaker at national and international courses/congress and I have taught duplex ultrasound method in GIUV and SIUMB courses at the Maggiore Hospital, Bologna and courses of echocolor Doppler of extracranial and intracranial arteries at the Stroke Unit of S. Maria Nuova Hospital, Reggio Emilia.