Vertebral artery dissection

Case contributed by Mariia Anisimova
Diagnosis almost certain

Presentation

A 34-year-old woman presented with a severe neck pain. She had a history of trauma one day ago.

Patient Data

Age: 34
Gender: Female
ultrasound

Dissection of the vascular wall of the vertebral artery in the segment at the entrance to C6 with color Doppler mode of this region showing flow. 

Case Discussion

Generally accepted method of diagnosis of vertebral arteries dissection is considered MRI, but an experienced sonographer may suggest the diagnosis of dissection on the basis of the characteristic features 1,2. Intravascular echoes are non-specific findings of dissection, but the expansion of the arterial lumen in one section and the normal diameter of the other section in conjunction with intravascular echo making it a more certain diagnosis. In this case, MRI was used to verify the diagnosis, which showed intramural hematoma on T1 fat saturated sequences.

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