FATAL INTRACRANIAL ARTERIAL DISSECTION - CLINICAL PATHOLOGICAL CORRELATION

The clinical pathological features of fatal arterial dissection confined to the intracranial vessels are described. Three patients with anterior circulation dissections presented with focal ischemic neurological deficits and pathological examination of involved vessels revealed a dissection plane between internal elastic lamina and media accompanied by intravascular thrombosis. Three of 4 patients with posterior circulation dissections had clinical pathological features of subarachnoid hemorrhage and at necropsy had transmural dissections. Primary vasculopathies either degenerative or inflammatory were not identified in affected vessels. The pathogenesis of intracranial arterial dissection is discussed and the clinical features are correlated with the pathological abnormalities.