Management of Carotid and Vertebral Artery Dissection

Abstract

This literature review aims at understanding the main approaches to diagnostics and treatment of cervical artery dissection. Since this is a complex condition which involves several specialties, a clear and concise approach is necessary to prevent significant mortality and morbidity in affected patients. Cervical artery dissection most commonly is caused by trauma to the head and neck region which may be so subtle in nature that patients might not even remember it anymore when presenting to the emergency room. A thorough physical examination followed by appropriate imaging is therefore pivotal. Diagnostic modalities include CTA or MRI/MRA as first-line modalities and doppler ultrasound and digital subtraction angiography as alternatives. Management mostly consists of medical treatment alone which included intravenous thrombolysis and subsequent stroke prevention with antiplatelets or anticoagulants. Some patients may benefit from interventional therapy such as endovascular stenting of the dissected artery. Outcomes of patients suffering from cervicocephalic dissection are usually favorable thanks to the advancement in treatment techniques but also due to the young patient population.