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Rofo 2007; 179(2): 119-129
DOI: 10.1055/s-2006-927205
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Kraniale und zervikale arterielle Gefäßverletzungen: Bildgebung und Therapie

Injury of Craniocervical Arteries: Imaging Findings and TherapyS. Hähnel1 , C. Stippich1 , M. Hartmann1 , B. Kress1
  • 1Neurologische Klinik, Abt. Neuroradiologie, Universitätsklinikum Heidelberg
Further Information

Publication History

eingereicht: 21.8.2006

angenommen: 10.10.2006

Publication Date:
07 March 2008 (online)

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Zusammenfassung

Direkte oder indirekte Verletzungen der Kopf-Hals-Gefäße können infolge von Unfällen, durch Tumorarrosion oder sogar spontan entstehen. Moderne nichtinvasive neuroradiologische Verfahren wie CT- und MR-Angiographie ermöglichen es, eine Vielzahl dieser Läsionen nachzuweisen. Die Therapie solcher Gefäßverletzungen kann häufig endovaskulär erfolgen. Wir beschreiben in dieser Übersicht die neuroradiologischen Phänomene von zervikalen und kranialen Gefäßverletzungen und gehen auf endovaskuläre Behandlungsmöglichkeiten ein.

Abstract

Direct or indirect injury of craniocervical vessels may be the consequence of an accident, may result from tumor arrosion, or may even occur spontaneously. Many of these vascular lesions can be detected using modern non-invasive vascular imaging techniques such as CT angiography and MR angiography. These traumatic vascular lesions can usually be treated using endovascular techniques. This overview describes neuroradiological findings for traumatic lesions of cervical and cranial vessels as well as endovascular treatment options.

Key words

trauma - vascular - head/neck - interventional procedures - MR angiography - CT angiography

Literatur

  • 1 Schievink W I. Spontaneous dissection of the carotid and vertebral arteries.  N Engl J Med. 2001;  344 898-906
    Google Scholar
  • 2 Giroud M, Fayolle H, Andre N. et al . Incidence of internal carotid artery dissection in the community of Dijon.  J Neurol Neurosurg Psychiatry. 1994;  57 1443
    Google Scholar
  • 3 Bogousslavsky J, Pierre P. Ischemic stroke in patients under age 45.  Neurol Clin. 1992;  10 113-124
    Google Scholar
  • 4 Dziewas R, Konrad C, Drager B. et al . Cervical artery dissection - clinical features, risk factors, therapy and outcome in 126 patients.  J Neurol. 2003;  250 1179-1184
    Google Scholar
  • 5 Hufnagel A, Hammers A, Schonle P W. et al . Stroke following chiropractic manipulation of the cervical spine.  J Neurol. 1999;  246 683-688
    Google Scholar
  • 6 Grau A J, Brandt T, Buggle F. et al . Association of cervical artery dissection with recent infection.  Arch Neurol. 1999;  56 851-856
    Google Scholar
  • 7 Caplan L R, Biousse V. Cervicocranial arterial dissections.  J Neuroophthalmol. 2004;  24 299-305
    Google Scholar
  • 8 Mohr A, Ebert S, Knauth M. Spontane Dissektion der Arteria carotis interna mit ipsilateralem Collet-Sicard-Syndrom.  Fortschr Röntgenstr. 2006;  178 444-446
    Google Scholar
  • 9 Nassenstein I, Kramer S C, Niederstadt T. et al . Inzidenz zerebraler Ischämien bei Patienten mit dem Verdacht einer spontanen Dissektion der extrakraniellen Arterien.  Fortschr Röntgenstr. 2005;  177 1532-1539
    Google Scholar
  • 10 Houser O W, Mokri B, Sundt Jr. TM. et al . Spontaneous cervical cephalic arterial dissection and its residuum: angiographic spectrum.  AJNR Am J Neuroradiol. 1984;  5 27-34
    Google Scholar
  • 11 Bradley Jr. WG. MR appearance of hemorrhage in the brain.  Radiology. 1993;  189 15-26
    Google Scholar
  • 12 Fiebach J, Brandt T, Knauth M. et al . MRT mit Fettsuppression zur Darstellung des Wandhämatoms bei spontaner Dissektion der A. carotis interna.  Fortschr Röntgenstr. 1999;  171 290-293
    Google Scholar
  • 13 Kadkhodayan Y, Jeck D T, Moran C J. et al . 3rd. Angioplasty and stenting in carotid dissection with or without associated pseudoaneurysm.  AJNR Am J Neuroradiol. 2005;  26 2328-2335
    Google Scholar
  • 14 Koscielny S, Beleites E, Schumann D. Moderne Möglichkeiten der palliativen chirurgischen Therapien bei inkurablen Kopf-Hals-Tumoren.  Der Onkologe. 2003;  8 165-168
    Google Scholar
  • 15 Wurm J, Gode U, Fucak A. Ligature of the carotid arteries performed prophylactically or as an emergency procedure in patients with malignant tumours of the head and neck.  Hno. 2000;  48 22-27
    Google Scholar
  • 16 Witz M, Korzets Z, Shnaker A. et al . Delayed carotid artery rupture in advanced cervical cancer - a dilemma in emergency management.  Eur Arch Otorhinolaryngol. 2002;  259 37-39
    Google Scholar
  • 17 Connors J J, Wojak J C. Interventional Neuroradiology. Strategies and practical techniques New York; Elsevier 1999
    Google Scholar
  • 18 Holzmann D, Kaufmann T, Pedrini P. et al . Posterior epistaxis: endonasal exposure and occlusion of the branches of the sphenopalatine artery.  Eur Arch Otorhinolaryngol. 2003;  260 425-428
    Google Scholar
  • 19 Li J R, Qian J, Shan X Z. et al . Evaluation of the effectiveness of preoperative embolization in surgery for nasopharyngeal angiofibroma.  Eur Arch Otorhinolaryngol. 1998;  255 430-432
    Google Scholar
  • 20 Ritter C, Adebahr G. Stab injuries of the skull and brain.  Z Rechtsmed. 1986;  96 229-234
    Google Scholar
  • 21 Steigerwald C, Draf W, Hofmann E. et al . Angiography of the carotid artery in centro-lateral skull base fractures?.  Laryngorhinootologie. 2005;  84 910-914
    Google Scholar
  • 22 Robbs J V. Penetrating vascular injuries: principles of diagnosis and management.  Gefäßchirurgie. 2002;  7 195-201
    Google Scholar
  • 23 Barrow D L, Spector R H, Braun I F. et al . Classification and treatment of spontaneous carotid-cavernous sinus fistulas.  J Neurosurg. 1985;  62 248-256
    Google Scholar
  • 24 Ringer A J, Salud L, Tomsick T A. Carotid cavernous fistulas: anatomy, classification, and treatment.  Neurosurg Clin N Am. 2005;  16 279-295, viii
    Google Scholar
  • 25 Parkinson D. Transcavernous repair of carotid cavernous fistula. Case report.  J Neurosurg. 1967;  26 420-424
    Google Scholar
  • 26 Helmke K, Kruger O, Laas R. The direct carotid cavernous fistula: a clinical, pathoanatomical, and physical study.  Acta Neurochir. 1994;  127 1-5
    Google Scholar
  • 27 Djindjian R, Merland J, Theron J. Superselective Arteriography of the external carotid artery. New York; Springer 1977: 606-628
    Google Scholar
  • 28 Kiyosue H, Hori Y, Okahara M. et al . Treatment of intracranial dural arteriovenous fistulas: current strategies based on location and hemodynamics, and alternative techniques of transcatheter embolization.  Radiographics. 2004;  24 1637-1653
    Google Scholar
  • 29 Mayer T E, Fesl G, Yousry T. et al . Diagnosis and treatment of cranial arteriovenous dural fistulas.  Radiologe. 1999;  39 876-881
    Google Scholar
  • 30 Saatci I, Cekirge H S, Ozturk M H. et al . Treatment of internal carotid artery aneurysms with a covered stent: experience in 24 patients with mid-term follow-up results.  AJNR Am J Neuroradiol. 2004;  25 1742-1749
    Google Scholar
  • 31 Alexander M J, Smith T P, Tucci D L. Treatment of an iatrogenic petrous carotid artery pseudoaneurysm with a Symbiot covered stent: technical case report.  Neurosurgery. 2002;  50 658-662
    Google Scholar
  • 32 Stallmeyer M J, Morales R E, Flanders A E. Imaging of traumatic neurovascular injury.  Radiol Clin North Am. 2006;  44 13-39, vii
    Google Scholar
  • 33 Hosoya T, Adachi M, Yamaguchi K. et al . Clinical and neuroradiological features of intracranial vertebrobasilar artery dissection.  Stroke. 1999;  30 1083-1090
    Google Scholar
  • 34 Mizutani T, Kojima H, Asamoto S. Healing process for cerebral dissecting aneurysms presenting with subarachnoid hemorrhage.  Neurosurgery. 2004;  54 342-348
    Google Scholar
  • 35 Mizutani T, Miki Y, Kojima H. et al . Proposed classification of nonatherosclerotic cerebral fusiform and dissecting aneurysms.  Neurosurgery. 1999;  45 253-260
    Google Scholar
  • 36 Ohkuma H, Suzuki S, Shimamura N. et al . Dissecting aneurysms of the middle cerebral artery: neuroradiological and clinical features.  Neuroradiology. 2003;  45 143-148
    Google Scholar
  • 37 Ohkuma H, Suzuki S, Kikkawa T. et al . Neuroradiologic and clinical features of arterial dissection of the anterior cerebral artery.  AJNR Am J Neuroradiol. 2003;  24 691-699
    Google Scholar
  • 38 Ahn J Y, Han I B, Kim T G. et al . Endovascular treatment of intracranial vertebral artery dissections with stent placement or stent-assisted coiling.  AJNR Am J Neuroradiol. 2006;  27 1514-1520
    Google Scholar
  • 39 Anxionnat R, Melo Neto de JF, Bracard S. et al . Treatment of hemorrhagic intracranial dissections.  Neurosurgery. 2003;  53 289-301
    Google Scholar
  • 40 Doerfler A, Wanke I, Egelhof T. et al . Double-stent method: therapeutic alternative for small wide-necked aneurysms. Technical note.  J Neurosurg. 2004;  100 150-154
    Google Scholar

Prof. Dr. med. Stefan Hähnel

Neuroradiology, University of Heidelberg Medical Center

Im Neuenheimer Feld 400

69120 Heidelberg

Phone: ++49/62 21/56 75 66

Fax: ++49/62 21/56 46 73

Email: Stefan.Haehnel@med.uni-heidelberg.de

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