Arterial Dissection Diagnosis in Children

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In order to decide the best way to treat arterial dissection, it is first necessary to find the location of the blood vessel tear and to determine the extent of the damage. To do this, we use a number of imaging tests to get detailed images of the child’s blood vessels and brain tissue. Tests can include:

CT angiography (CTA)

CTA is based on a conventional computed tomography (CT) scan, which uses x-ray equipment and powerful computers to create cross-sectional images (often called “slices”) of the head, neck and brain. To this test, CTA adds a special dye (known as contrast) that is injected into a vein. A computer generates detailed 3D images of the blood vessels.

During the test, the child must briefly lie still on a table that slides slowly through a donut-shaped device. Young children may need sedation to help keep them still.

Magnetic resonance angiography (MRA)

Based on magnetic resonance imaging (MRI) technology, MRA also visualizes blood vessels in the brain, head and neck, but without the need for x-rays. Unlike CTA, many MRA scans can be done without injecting a dye into the veins to generate images of the vessels. Other parts of the MRI can also help us detect whether there has been any injury to the brain tissue. Children must lie still during the MRA and may therefore need sedation.

Catheter angiography

We sometimes recommend this invasive test, which is done under general anesthesia. A catheter (a flexible tube about the width of spaghetti) is placed directly into the child’s arteries. The catheter is used to inject a special dye, known as contrast, allowing us to get more detailed images.

The treatment team will provide advance instructions on how to prepare for these tests. In addition to the above imaging tests, our neurologist colleagues may conduct a variety of specific tests to assess the child’s brain function.

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