Cervical artery dissection

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Cervical artery dissection
Diagram of the vertebral artery
Synonyms
Pronounce	N/A
Specialty	N/A
Symptoms	Headache, neck pain, ischemic stroke
Complications	Stroke, subarachnoid hemorrhage
Onset
Duration
Types	Carotid artery dissection, vertebral artery dissection
Causes	Trauma, connective tissue disorders
Risks	Hypertension, smoking, migraine
Diagnosis	MRI, CT angiography
Differential diagnosis	Migraine, cluster headache, tension headache
Prevention
Treatment	Anticoagulation, antiplatelet therapy
Medication	Heparin, aspirin
Prognosis
Frequency
Deaths

A condition involving a tear in the cervical arteries

Cervical Artery Dissection

Diagram of the vertebral artery, one of the arteries that can be affected by cervical artery dissection.

Cervical artery dissection is a condition where there is a tear in one of the major arteries in the neck, specifically the carotid artery or the vertebral artery. This tear can lead to the formation of a blood clot, which may result in a stroke if the clot travels to the brain.

Pathophysiology

Cervical artery dissection occurs when there is a tear in the tunica intima, the innermost layer of the artery wall. This tear allows blood to enter the arterial wall and form a hematoma, which can lead to stenosis or complete occlusion of the artery. The dissection can also create a false lumen, which may lead to an aneurysm.

Causes

The exact cause of cervical artery dissection is not always clear, but it can be associated with:

• Trauma to the neck, such as from a car accident or sports injury.
• Connective tissue disorders, such as Ehlers-Danlos syndrome or Marfan syndrome.
• Hypertension and other vascular risk factors.

Symptoms

Symptoms of cervical artery dissection can vary but often include:

• Sudden onset of severe headache or neck pain.
• Horner's syndrome, characterized by ptosis, miosis, and anhidrosis.
• Ischemic stroke symptoms, such as weakness or numbness on one side of the body, difficulty speaking, or vision changes.

Diagnosis

Diagnosis of cervical artery dissection typically involves imaging studies such as:

• Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA).
• Computed tomography angiography (CTA).
• Ultrasound of the neck vessels.

Treatment

Treatment for cervical artery dissection may include:

• Anticoagulation therapy to prevent clot formation.
• Antiplatelet therapy, such as aspirin.
• In some cases, surgical intervention or endovascular procedures may be necessary.

Prognosis

The prognosis for individuals with cervical artery dissection varies. Many patients recover fully with appropriate treatment, but some may experience long-term neurological deficits if a stroke occurs.

See also

• Stroke
• Carotid artery dissection
• Vertebral artery
• Horner's syndrome