{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T15:57:37Z","timestamp":1770911857507,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,2,12]],"date-time":"2023-02-12T00:00:00Z","timestamp":1676160000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Spontaneous intracranial artery dissection (IAD) can be definitively diagnosed by detecting intramural hematoma (IMH) on arterial wall imaging. However, evidence of a time\u2010dependent natural history for the development of radiological findings is lacking. Therefore, this study aimed to determine when imaging detects IAD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We obtained data from our cohort databases between March 2011 and August 2018 on consecutive patients who had definite, probable, or possible IAD based on the multidisciplinary expert consensus criteria. We assessed IMH on initial and follow\u2010up high\u2010resolution three\u2010dimensional T1\u2010weighted imaging (HR\u20103D\u2010T1WI). We retrospectively investigated the association between IMH detection and days from symptom onset to initial HR\u20103D\u2010T1WI and compared the IMH detection rate with other definitive diagnostic arterial dissection findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We analyzed 106 patients (mean age\u00a0=\u00a051\u2009\u00b1\u200913\u2009years, 31 women) with at least initial HR\u20103D\u2010T1WI data. The final diagnoses were definite, probable, and possible IAD in 83, 18, and\u00a05 patients, respectively. IMHs were observed in 63 patients (59%, 95% confidence interval [CI] =\u200949%\u201369%). Overall IMH detection rate was 55% (95% CI\u00a0=\u00a045%\u201364%), 20% (95% CI\u00a0=\u00a03%\u201360%), 40% (95% CI\u00a0=\u00a021%\u201364%), and 50% (95% CI\u00a0=\u00a037%\u201363%) on the initial HR\u20103D\u2010T1WI and Days 3, 7, and 13, respectively. Among 68 patients evaluated with digital subtraction angiography and HR\u20103D\u2010T1WI, IMH was confirmed more frequently than other definitive diagnostic arterial dissection findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The overall IMH detection rate on HR\u20103D\u2010T1WI was &gt;50% and peaked in 1\u20132\u2009weeks. IMH was a frequently detectable finding for the diagnosis of IAD compared to other radiological findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15715","type":"journal-article","created":{"date-parts":[[2023,1,25]],"date-time":"2023-01-25T10:05:35Z","timestamp":1674641135000},"page":"1320-1326","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Sequential detection rates of intramural hematoma for diagnosing spontaneous intracranial artery dissection"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4241-3677","authenticated-orcid":false,"given":"Satoshi","family":"Hosoki","sequence":"first","affiliation":[{"name":"Department of Cerebrovascular Medicine National Cerebral and Cardiovascular Center  Suita Japan"},{"name":"Department of Neurology National Cerebral and Cardiovascular Center  Suita 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