PT  - JOURNAL ARTICLE
AU  - T Hosoya
AU  - N Watanabe
AU  - K Yamaguchi
AU  - H Kubota
AU  - Y Onodera
TI  - Intracranial vertebral artery dissection in Wallenberg syndrome.
DP  - 1994 Jun 01
TA  - American Journal of Neuroradiology
PG  - 1161--1165
VI  - 15
IP  - 6
4099  - http://www.ajnr.org/content/15/6/1161.short
4100  - http://www.ajnr.org/content/15/6/1161.full
SO  - Am. J. Neuroradiol.1994 Jun 01; 15
AB  - PURPOSE To assess the prevalence of vertebral artery dissection in Wallenberg syndrome. METHODS Sixteen patients (12 men, 4 women; mean age at ictus, 51.6 years) with symptoms of Wallenberg syndrome and an infarction demonstrated in the lateral medulla on MR were reviewed retrospectively. The study items were as follows: (a) headache as clinical signs, in particular, occipitalgia and/or posterior neck pain at ictus; (b) MR findings, such as intramural hematoma on T1-weighted images, intimal flap on T2-weighted images, and double lumen on three-dimensional spoiled gradient-recalled acquisition in a steady state with gadopentetate dimeglumine; (c) direct angiographic findings of dissection, such as double lumen, intimal flap, and resolution of stenosis on follow-up angiography; and (d) indirect angiographic findings of dissection (such as string sign, pearl and string sign, tapered narrowing, etc). Patients were classified as definite dissection if they had reliable MR findings (ie, intramural hematoma, intimal flap, and enhancement of wall and septum) and/or direct angiographic findings; as probable dissection if they showed both headache and suspected findings (ie, double lumen on 3-D spoiled gradient-recalled acquisition in a steady state or indirect angiographic findings); and as suspected dissection in those with only headache or suspected findings. RESULTS Seven of 16 patients were classified as definite dissection, 3 as probable dissection, and 3 as suspected dissection. Four patients were considered to have bilateral vertebral artery dissection on the basis of MR findings. CONCLUSIONS Vertebral artery dissection is an important cause of Wallenberg syndrome.