{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T15:11:52Z","timestamp":1751987512511,"version":"3.37.3"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ultraschall Med"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Spontaneous dissection of brain-supplying cervical arteries, which also includes findings after minor injuries, is one of the main causes of ischaemic strokes in young adults. Strokes due to dissection are usually due to arterio-arterial embolism. They are rarely the first symptom of dissection because an intraluminal thrombus must first develop.\u200aTherefore, early diagnosis of dissection can contribute to stroke prevention \u2013 through immediate therapy with anticoagulants or antiplatelet drugs. This article describes the diagnostic criteria and typical findings of spontaneous dissection, in which no dissecting membrane is to be expected as in aortic dissection. Traumatic dissections following blunt or penetrating injuries also present with different findings. Examiners should be aware of possible differential diagnoses whose ultrasound image may mimic a dissection. A frequently occurring but avoidable cause of misdiagnosis is idiopathic carotidynia. Ultrasound also enables differentiation between dissection and vasculitis or carotid web and detection of normal variants such as fenestration of the vertebral artery. Further possibilities for misdiagnosis may arise in the presence of a variant of the ascending pharyngeal artery or in extracranial vasospasm. The different imaging techniques for the detection of a dissection are complementary, as false-negative findings occur with all techniques; no method serves as the gold standard. In any case, ultrasound can make an important contribution to the detection of a dissection, and it is worth knowing the diagnostic criteria.<\/jats:p>","DOI":"10.1055\/a-2004-4986","type":"journal-article","created":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T00:06:51Z","timestamp":1675728411000},"page":"126-150","source":"Crossref","is-referenced-by-count":4,"title":["Ultrasound Criteria for Diagnosing Spontaneous Cervical Artery Dissections"],"prefix":"10.1055","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8762-9589","authenticated-orcid":false,"given":"Christian","family":"Arning","sequence":"additional","affiliation":[{"name":"Neurology, Praxis Neuro-Ultraschall, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,2,6]]},"reference":[{"key":"ref1","first-page":"50","article-title":"Cervical artery dissection: emerging risk factors","volume":"4","author":"S Micheli","year":"2010","journal-title":"Open Neurol J"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"3155","DOI":"10.1161\/STR.0000000000000016","article-title":"Cervical arterial dissections and association with cervical manipulative therapy: a statement for healthcare professionals from the american heart association\/american stroke association","volume":"45","author":"J Biller","year":"2014","journal-title":"Stroke"},{"key":"ref3","first-page":"581","article-title":"Clinical features of dissection of the cervical brain-supplying arteries","volume":"119","author":"C Arning","year":"2022","journal-title":"Dtsch Arztebl Int"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"3353","DOI":"10.1007\/s00415-022-10964-9","article-title":"Vertebral artery dissection after-and also before-chirotherapy","volume":"269","author":"C Arning","year":"2022","journal-title":"J Neurol"},{"volume-title":"S1-Leitlinie Spontane Dissektionen der extra- und intrakraniellen hirnversorgenden Arterien","year":"2016","author":"E Ringelstein","key":"ref5"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1038\/ncpneuro0683","article-title":"Dissections of brain-supplying arteries","volume":"4","author":"L R Caplan","year":"2008","journal-title":"Nat Clin Pract Neurol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1055\/s-2007-1017920","article-title":"Eine seltene Schlaganfallursache: die Aortendissektion","volume":"22","author":"C Arning","year":"1995","journal-title":"Akt Neurol"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1097\/WCO.0000000000000056","article-title":"Pathophysiology and risk factors of cervical artery dissection: what have we learnt from large hospital-based cohorts?","volume":"27","author":"S Debette","year":"2014","journal-title":"Curr Opin Neurol"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1055\/s-2008-1027932","article-title":"Nicht arteriosklerotische Erkrankungen der Halsarterien","volume":"29","author":"C Arning","year":"2008","journal-title":"Ultraschall in Med"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1161\/STROKEAHA.113.001654","article-title":"Characteristics and outcomes of patients with multiple cervical artery dissection","volume":"45","author":"Y B\u00e9jot","year":"2014","journal-title":"Stroke"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.jocn.2008.04.005","article-title":"Sensitivity of neurovascular ultrasound for the detection of spontaneous cervical artery dissection","volume":"16","author":"J Nebelsieck","year":"2009","journal-title":"J Clin Neurosci"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1159\/000092386","article-title":"Ultrasound diagnosis of cervical artery dissection","volume":"21","author":"D H Benninger","year":"2006","journal-title":"Front Neurol Neurosci"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1007\/s00115-004-1754-z","article-title":"Die Karotidynie im Ultraschallbild: Mythos, Syndrom oder Krankheitsbild?","volume":"75","author":"C Arning","year":"2004","journal-title":"Nervenarzt"},{"key":"ref14","first-page":"201","article-title":"Ultrasonography of carotidynia","volume":"26","author":"C Arning","year":"2005","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"e192","DOI":"10.1161\/STROKEAHA.122.038639","article-title":"Carotid Web Mimicking Dissection","volume":"53","author":"C Arning","year":"2022","journal-title":"Stroke"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1055\/s-2003-814834","article-title":"Fensterung der A. vertebralis \u2013 Verwechslungsm\u00f6glichkeit mit einer A. vertebralis-Dissektion","volume":"31","author":"C Arning","year":"2004","journal-title":"Akt Neurol"},{"issue":"01","key":"ref17","first-page":"114","article-title":"The ascending pharyngeal artery and its relevance for neurosurgical and endovascular procedures","volume":"65","author":"D D Cavalcanti","year":"2009","journal-title":"Neurosurgery"},{"key":"ref18","first-page":"460","article-title":"Potential errors in vascular patients due to anatomical variants of the ascending pharyngeal artery","volume":"89","author":"C Pohlmann","year":"2018","journal-title":"Nervenarzt"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1161\/01.STR.29.5.1063","article-title":"Cervical carotid artery vasospasms causing cerebral ischemia: detection by immediate vascular ultrasonographic investigation","volume":"29","author":"C Arning","year":"1998","journal-title":"Stroke"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"106036","DOI":"10.1016\/j.jstrokecerebrovasdis.2021.106036","article-title":"Pediatric Case of Life-Threatening Stroke Caused by Reversible Cerebral Vasoconstriction Syndrome with Spontaneous Cervical Internal Carotid Artery Vasospasm: A Case Report","volume":"30","author":"Y Fujii","year":"2021","journal-title":"J Stroke Cerebrovasc Dis"}],"container-title":["Ultraschall in der Medizin - European Journal of Ultrasound"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2004-4986.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T23:49:52Z","timestamp":1680220192000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2004-4986"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,6]]},"references-count":20,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2023,3,30]]},"published-print":{"date-parts":[[2023,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2004-4986","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0172-4614","1438-8782"],"issn-type":[{"type":"print","value":"0172-4614"},{"type":"electronic","value":"1438-8782"}],"subject":[],"published":{"date-parts":[[2023,2,6]]}}}