A narrative review of pathophysiological mechanisms associated with cervical artery dissection.
OBJECTIVE
The purpose of this narrative review was to describe pathophysiological risk factors that have been reported in association with cervical artery dissection (CAD) and to discuss the strength of those associations.


METHODS
MEDLINE, PubMed, Manual Alternative and Natural Therapy System (MANTIS), and CINAHL databases were searched for the years 1966 through September 2006. Additionally, the literature generated by the searches was culled for relevant citations incorporated within the articles.


RESULTS
The search strategy generated a total of 130 distinct citations, of which 49 were determined to be relevant after applying the study's selection criteria. An additional 6 references were harvested from the reference lists of the included articles.


CONCLUSIONS
The most compelling pathophysiological risk factors have to do with connective tissue abnormalities, which may contribute to a weakening of the vascular wall making it more susceptible to tearing. However, the exact pathogenesis of CAD is uncertain, especially in cases that occur spontaneously, are related to trivial trauma, or occur in the absence of discernable risk factors.
Haneline
Michael
M
Palmer College of Chiropractic West, 90 East Tasman Drive, San Jose, CA 95134, USA. michael.haneline@palmer.edu
Lewkovich
Gary N
GN