[Contribution of the cervical scanner with injection in the diagnosis of vertebral artery dissection].

Vertebral artery dissection is the first diagnosis that must be suspected by a 40 years old patient with posterior fossa ischemic signs. CT data from six cases of spontaneous or post-traumatic vertebral artery dissections are reviewed. Cervical CT is performed after contrast medium injection from C7 to C0 with 1.5 mm thick slices and a 2 mm gap or with a spiral mod including millimetric reconstruction. The enhancement of the vascular wall, the hypodense hematoma surrounding a stenotic and eccentric lumen, and the enlargement of the artery are typical for a vertebral artery dissection. CT findings were correlated with angiography that is still considered to be the gold standard for this diagnosis. Among noninvasive technics including MRI, duplex scanning and CT, the latter appears very accurate to diagnose vertebral artery dissection.