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Dissection, Carotid and Vertebral Artery

Laura B. Bishop, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

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

  • Intramural hematoma, the pathophysiologic hallmark of C...

DIAGNOSIS

HISTORY

  • 2/3 of CAD patients present as a TIA or stroke and some may present with both ischemic and local symptoms.

  • In spontaneous CaAD dissections, symptoms can be divided into local and those...

TREATMENT

GENERAL MEASURES

Smoking cessation, following a healthy diet that is low in salt, fat, and calories, and weight management can prevent the risk factors associated with increased risk of CAD. 

MEDICATION

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Follow-up with a neurologist is highly recommended.

  • Repeat imaging is useful to guide further treatment decisions.

  • Anticoagulation should be managed as required.

Patient Monitoring

REFERENCES

1
Peng J, Liu Z, Luo, C, et al. Treatment of cervical artery dissection: antithrombotics, thrombolysis, and endovascular therapy. BioMed Res Int. 2017;17:1-6.
2
Engelter...

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

SNOMED

  • 705066004 Internal carotid artery dis...

CLINICAL PEARLS

  • CaAD and VAD are major causes of stroke in the young.

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

  • In the radiographic detection of CAD, CTA is widely available and...

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