Cervical carotid artery dissection: current review of diagnosis and treatment.
Carotid artery dissection is a cause of stroke, especially in young and middle-aged patients. A dissection occurs when there is an intimal tear or rupture of the vasa vasorum, leading to an intramural hematoma, which is thought to result from trauma or can occur spontaneously, and is likely multifactorial, involving environmental and intrinsic factors. The clinical diagnosis of carotid artery dissection can be challenging, with common presentations including pain, partial Horner syndrome, cranial nerve palsies, or cerebral ischemia. With the use of noninvasive imaging, including magnetic resonance and computed tomography angiography, the diagnosis of carotid dissection has increased in frequency. Treatment options include thrombolysis, antiplatelet or anticoagulation therapy, endovascular or surgical interventions. The choice of appropriate therapy remains controversial as most carotid dissections heal on their own and there are no randomized trials to compare treatment options.
Department of Radiology, Bronx-Lebanon Hospital Center, 1650 Grand Concourse, Bronx, NY 10457, USA. rajpatel33@gmail.com
Raj Ramabhai
RR
Patel
Richard
R
Adam
Catherine
C
Maldjian
Christie M
CM
Lincoln
Annie
A
Yuen
Amrita
A
Arneja
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D002545:Brain Ischemia / Q000209:etiology; D020215:Carotid Artery, Internal, Dissection / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D003389:Cranial Nerve Diseases / Q000209:etiology; D003952:Diagnostic Imaging / Q000379:methods; D042241:Early Diagnosis; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D020773:Headache Disorders / Q000209:etiology; D006732:Horner Syndrome / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology; D012008:Recurrence; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000209:etiology; D015912:Thrombolytic Therapy / Q000379:methods; D014012:Tinnitus / Q000209:etiology; D016896:Treatment Outcome
D000925:Anticoagulants