Dissection Of Carotid & Vertebral Arteries

Dissection of the carotid or vertebral arteries (collectively known as the cervical arteries) refers to the separation of the tunica media and tunica intima of a vessel. Cervical artery dissection can cause stenosis, thrombosis, or distal embolization. Most affected individuals are adults. Cervical artery dissections may occur after major trauma (e.g., motor vehicle crashes) or minor events (e.g., sneezing) and typically manifest with a headache, which may be followed by ischemic features (e.g., stroke) a few hours or days later. CT angiography (CTA) or MR angiography (MRA) of the head and neck is used to establish the diagnosis. Management is based on clinical presentation and includes antithrombotic agents for most patients, thrombolysis for patients with signs of ischemic stroke, and surgery in selected cases. Complications include recurrent stroke and/or dissection, delayed formation of a dissecting aneurysm, and complications associated with ischemic stroke.