Noninvasive imaging of craniocervical artery dissection

Craniocervical arterial dissections (CCAD) are being increasingly identified due to growing awareness of diverse clinical picture along with advances in imaging technologies. Although rare, CCADare frequent cause of stroke in young adults. Neurosonological tests serve as an excellent noninvasive screening and monitoring tool, but brainMR andMRA are necessary for confirmation of the diagnosis. Ultrasound examination may show direct or indirect signs. Direct signs are: echolucent intramural hematoma, string sign, double lumen, or stenosis and/or occlusion of an arterial segment usually not affected by atherosclerosis. Indirect signs are: increased or decreased pulsatility index upstream or downstream of the suspected lesion, more than 50% difference in blood flow velocity compared to the unaffected side, or detection of intracranial collateral flow. Since CCAD have been increasingly identified, a whole spectrum of clinical pictures are been recognizes. Neurosonology showed high sensitivity in CCAD detection