{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:51:02Z","timestamp":1787028662284,"version":"build-2736575974"},"reference-count":56,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T00:00:00Z","timestamp":1758326400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Cervical artery dissection (CAD) is a leading cause of acute ischemic stroke among young and middle-aged patients. Currently, the growing availability of high-resolution magnetic resonance imaging (MRI), particularly fat-saturated T1-weighted black-blood SPACE sequences, allows the non-invasive, rapid, and reliable diagnosis of multiple arterial dissections. Methods: We reported our experience from two tertiary stroke centers of patients diagnosed with spontaneous multiple cervical artery dissections, detected with high-resolution MRI, during a three-year period (2022\u20132025). Results: Among 95 consecutive patients with CAD, 11 patients (mean age: 48 \u00b1 9 years, 6 (55%) females) were diagnosed with multiple symptomatic or asymptomatic CADs, whereas in 84 patients (mean age: 49 \u00b1 11 years, 32 (38%) females) a single CAD was detected. In all patients, high-resolution MRI and MR-angiography were performed, whereas digital subtraction angiography (DSA) with simultaneous evaluation of renal arteries was conducted in nine patients. A history of trauma or chiropractic manipulations, intense physical exercise prior to symptom onset, recent influenza-like illness, and recent childbirth in a young female patient were reported as predisposing risk factors. Cervicocranial pain, cerebral infarctions leading to focal neurological signs, and Horner\u2019s syndrome were among the most commonly documented symptoms. Characteristic findings in the high-resolution 3D T1 SPACE sequence were detected in all patients. Fibromuscular dysplasia and Eagle syndrome were detected in four patients and one patient, respectively. Eight patients were treated with antiplatelets, whereas three patients received anticoagulation with low-molecular-weight heparin. There was only one case of stroke recurrence during a mean follow-up period of 9 \u00b1 4 months. Conclusions: This case series highlights the utility of specific high-resolution MRI sequences as a very promising method for detecting multiple CADs in young patients. The systematic use of these sequences could enhance the sensitivity of detecting multiple cervical CADs, affecting also the thorough investigation for underlying connective tissue vasculopathies, stratifying the risk for first-ever or recurrent ischemic stroke, and influencing acute reperfusion and secondary prevention therapeutic strategies.<\/jats:p>","DOI":"10.3390\/jcm14186635","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T12:08:03Z","timestamp":1758542883000},"page":"6635","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Spontaneous Multiple Cervical Artery Dissections Detected with High-Resolution MRI: A Prospective, Case-Series Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Aikaterini","family":"Foska","sequence":"first","affiliation":[{"name":"Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, \u201cAttikon\u201d University Hospital, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7229-2610","authenticated-orcid":false,"given":"Aikaterini","family":"Theodorou","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, \u201cAttikon\u201d University Hospital, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8315-5846","authenticated-orcid":false,"given":"Maria","family":"Chondrogianni","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, \u201cAttikon\u201d University Hospital, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0050-284X","authenticated-orcid":false,"given":"Georgios","family":"Velonakis","sequence":"additional","affiliation":[{"name":"Second Department of Radiology, National and Kapodistrian University of Athens, School of Medicine, \u201cAttikon\u201d University Hospital, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanos","family":"Lachanis","sequence":"additional","affiliation":[{"name":"Iatropolis Magnetic Resonance Diagnostic Centre, 15231 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7002-9795","authenticated-orcid":false,"given":"Eleni","family":"Bakola","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, \u201cAttikon\u201d University Hospital, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0052-5678","authenticated-orcid":false,"given":"Georgia","family":"Papagiannopoulou","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, \u201cAttikon\u201d University Hospital, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1347-8543","authenticated-orcid":false,"given":"Alexandra","family":"Akrivaki","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, \u201cAttikon\u201d University Hospital, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3496-7543","authenticated-orcid":false,"given":"Stella","family":"Fanouraki","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, \u201cAttikon\u201d University Hospital, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4885-1766","authenticated-orcid":false,"given":"Christos","family":"Moschovos","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, \u201cAttikon\u201d University Hospital, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiota-Eleni","family":"Tsalouchidou","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, \u201cAttikon\u201d University Hospital, 12462 Athens, Greece"},{"name":"Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0130-4826","authenticated-orcid":false,"given":"Ermioni","family":"Papageorgiou","sequence":"additional","affiliation":[{"name":"Stroke Unit, Metropolitan Hospital, 18547 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athina","family":"Andrikopoulou","sequence":"additional","affiliation":[{"name":"Stroke Unit, Metropolitan Hospital, 18547 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3993-2545","authenticated-orcid":false,"given":"Klearchos","family":"Psychogios","sequence":"additional","affiliation":[{"name":"Stroke Unit, Metropolitan Hospital, 18547 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8317-6428","authenticated-orcid":false,"given":"Odysseas","family":"Kargiotis","sequence":"additional","affiliation":[{"name":"Stroke Unit, Metropolitan Hospital, 18547 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9630-6949","authenticated-orcid":false,"given":"Apostol\u03bfs","family":"Safouris","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, \u201cAttikon\u201d University Hospital, 12462 Athens, Greece"},{"name":"Stroke Unit, Metropolitan Hospital, 18547 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Effrosyni","family":"Koutsouraki","sequence":"additional","affiliation":[{"name":"First Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, AHEPA University 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Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7443-5179","authenticated-orcid":false,"given":"Sotirios","family":"Giannopoulos","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, \u201cAttikon\u201d University Hospital, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7757-609X","authenticated-orcid":false,"given":"Lina","family":"Palaiodimou","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, \u201cAttikon\u201d University Hospital, 12462 Athens, 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