THE CONTRIBUTION OF CERVICAL CT-SCAN WITH CONTRAST-MEDIUM INJECTION FOR DIAGNOSIS OF VERTEBRAL ARTERY DISSECTION

Vertebral artery dissection is the first diagnosis that must be suspec ted by a 40 years old patient with posterior fossa ischemic signs. CT datas from six cases of spontaneous or post-traumatic vertebral artery dissections are reviewed. Cervical CT is performed after contrast med ium injection from C7 to CO with 1.5 mm thick slices and a 2 mm gap or with a spiral mod including millimetric reconstruction. The enhanceme nt of the vascular wall, the hypodense hematoma surrounding a stenotic and eccentric lumen, and the enlargement of the artery are typical fo r a vertebral artery dissection. CT findings were correlated with angi ography that is still considered to be the gold standard for this diag nosis. Among noninvasive technics including MRI, duplex scaning and CT , the latter appears very acurate to diagnose vertebral artery dissect ion.