Clinical manifestation and treatment strategy for non hemorrhagic cerebral arterial dissection.

Spontaneous dissections of cerebral and cervical artery are relatively uncommon lesions in Japan. Although reported cases of cerebral and cervical arterial dissection are gradually increasing, natural history and optimal treatment remain unclear. The purpose of this study was to clarify the clinical features, natural history, and optimal treatment for patients suffering from non-hemorrhagic cerebral arterial dissection. Fifty-four males and 14 females with cerebral or cervical arterial dissection were treated between January 1998 and December 2003 at the Stroke Center, Sendal Medical Center in Japan. Although most patients suffering from non-hemorrhagic cerebral arterial dissection recover well by conservative treatments, some cases require surgical treatment if they are complicated by enlargement of aneurysms, cerebral ischemia due to bilateral vertebral arterial dissection.