- Cervical artery dissections include carotid or vertebral artery dissections and can be seen in patients of all ages, although they are a more common cause of stroke in young patients
- Symptoms may be somewhat non-specific (headache, neck pain, dizziness) or can be more localized (partial Horner syndrome with carotid artery dissection, etc.)
- Minor trauma (neck manipulation, yoga, minor falls, swimming) is considered a risk factor for spontaneous cervical artery dissection but more significant traumatic injury (blunt trauma to head/neck) is increasingly recognized as a cause of cervical artery dissection as well
- Diagnostic imaging options include CTA, which has 90% sensitivity for detection of cervical artery dissection, and MRA, which has a sensitivity ranging from 75-100%
- Patients with spontaneous cervical artery dissection and acute stroke are candidates for tPA in accordance with ischemic stroke guidelines
- After initial acute management, patients are managed with anticoagulation or antiplatelet therapy (if tPA has been given, it is started 24 hrs after being administered)
Shea K, Stahmer S, Carotid and Vertebral Arterial Dissections in the Emergency Department. Emergency Medicine Practice. April 2012;14:1-24.