Journal
LANCET NEUROLOGY
Volume 14, Issue 6, Pages 640-654Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/S1474-4422(15)00009-5
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Funding
- Emil Aaltonen Foundation
- Maud Kuistila Memorial Foundation
- Helsinki University Central Hospital Research Fund
- Biomedicum Helsinki Foundation
- Helsinki University Medical Foundation
- BMS
- Pfizer
- Bayer
- Boston Scientific
- Boehringer Ingelheim
- Johnson and Johnson
- Lundbeck
- Mitsubishi Pharma
- H Lundbeck A/S
- Sanofi-Aventis
- PhotoThera Inc
- BrainsGate
- Orion Pharma
- Schering Plough
- Concentric Medical
- Helsinki University Central Hospital
- Sigrid Juselius Foundation
- Liv och Halsa Foundation
- Biocenter Finland
- Biocentrum Helsinki
- European Union
- Finnish Academy of Sciences
- National Institutes of Health
- Professio Finland
- University of Helsinki
- Finnish Medical Association
- Finnish Neurological Association
- University of Donau (Krems)
- Salus Ansvar Foundation Award
- Finnish Medical Association Quality Award
- European Stroke Conference
- European Federation of Neurological Societies Conference
- European Stroke Organisation
- University of Rostock
- University of Bielefeld, Australia
- New Zealand Stroke Society
- Austrian Stroke Society
- University of Leuven
- University of Tarto
- Nordic Stroke Conference
- Polish Neuroscience Society
- Greek Internal Medicine Society
- University of Donau, Krems
- Thrombolysis and Thrombectomy Acute Stroke Treatment Conference
- World Stroke Conference
- University of Bern
- University of Tuebingen
- German Psychological Society
- Covidien
- Swiss National Science Foundation
- Swiss Heart Foundation
- SHIRE
- Nestle Health Services
- Agence Nationale de la Recherche
- Dutch Heart Foundation [2007/B45]
- National Institute of Health [U10 NS086606-01]
- American Heart Association/American Stroke Association (AHA/ASA) National Clinical Research Program [AHA 3CRP141400001]
- National Institute of Health and Research senior investigator award
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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.
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