Treatment of Intracranial Dissections
The authors examined 29 dissections in 27 patients over a 16 year period.
Just under 1/2 of the patients (12) had endovascular treatment in the acute period. 16 other dissections were not treated for anatomic reasons and one patient underwent surgical wrapping. In most cases the strategy used was endovascular occlusion proximal or at the dissection site. 19 of the cases were in the V4 (intracranial) segment of the vertebral artery. There were also 2 isolated PICA, basilar and 1 isolated ACA, and PCA dissections noted.
Commentary rendered by Drs. Harbaugh noted that sometimes these lesions may present with ischemic symptoms yet still have a future hemorrhage risk. Dr. Hopkins emphasized the potential future role of intracranial stents in this disease entity.