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Dissection, Carotid and Vertebral Artery

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Cervical artery dissection (CAD) is subcategorized into internal carotid artery dissection (ICAD) and vertebral artery dissection (VAD).

  • CAD accounts for 2–2.5% of all ischemic stroke...

DIAGNOSIS

HISTORY

  • CAD presents as TIA or stroke in approximately 2/3 of patients, although often, affected individuals may present with both ischemic and local symptoms.

  • In spontaneous ICAD dissections,...

TREATMENT

MEDICATION

First Line

  • Intravenous thrombolysis (IVT) can provide recanalization of thrombus at the site of dissection or distal embolus. It is not contraindicated if patient presents with acut...

REFERENCES

1
Arnold M, Bousser MG, Fahrni G, et al. Vertebral artery dissection: presenting findings and predictors of outcome. Stroke.  2006;37(10):2499–2503. {L-End} [View Abstract on OvidMedli...

ADDITIONAL READING

Lyrer P, Engelter S. Antithrombotic drugs for carotid artery dissection. Cochrane Database Syst Rev.  2010;(10):CD000255. 

CODES

ICD10

  • I77.71 Dissection of carotid artery

  • I77.74 Dissection of vertebral artery

  • I72.8 Aneurysm of other specified arteries

  • I72.0 Aneurysm of carotid artery

ICD9

  • 443.21 Dissection of carotid artery

  • 443....

CLINICAL PEARLS

  • CAD is composed of ICAD and VAD and is a major cause of stroke in the young.

  • A majority of patients have both ischemic and localized symptoms.

  • In the radiographic detection of CAD, MRI h...

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