title: Interventional management for secondary intracranial extension of spontaneous cervical arterial dissection.
abstract: BACKGROUND
  Spontaneous cervical artery dissection (sCAD) is an important etiology of stroke and subarachnoid hemorrhage (SAH) in young patients. Anticoagulation and platelet antiaggregant medications are the treatment of choice, while the indications of endovascular treatment are still to be defined.
  
  
  METHODS
  We report two cases of medically refractory sCAD with intracranial extension treated successfully with multiple intra and extracranial stents. The patients were evaluated at 4 years and 1-year follow-up.
  
  
  CONCLUSIONS
  Progressive, spontaneous cervical artery dissection with intracranial extension despite adequate medical therapy is rare and associated with worse prognosis. Given the rapid evolution of interventional technology and techniques, if we are better able to predict the cohort of patients that fail medical management, earlier endovascular therapy may be considered.
authors.affiliation: Division of Interventional Neuroradiology, Department of Neurological Surgery, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY.
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Smith
authors.forename: Alejandro
authors.initials: A
authors.lastname: Santillan
authors.forename: Alan
authors.initials: A
authors.lastname: Segal
authors.forename: Athos
authors.initials: A
authors.lastname: Patsalides
authors.forename: Y Pierre
authors.initials: YP
authors.lastname: Gobin