title: Intracranial vertebral artery dissections: evolving perspectives.
abstract: Intracranial vertebral artery dissection (VAD) represents the underlying etiology in a significant percentage of posterior circulation ischemic strokes and subarachnoid hemorrhages. These lesions are particularly challenging in their diagnosis, management, and in the prediction of long-term outcome. Advances in the understanding of underlying processes leading to dissection, as well as the evolution of modern imaging techniques are discussed. The data pertaining to medical management of intracranial VADs, with emphasis on anticoagulants and antiplatelet agents, is reviewed. Surgical intervention is discussed, including, the selection of operative candidates, open and endovascular procedures, and potential complications. The evolution of endovascular technology and techniques is highlighted.
authors.affiliation: Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Ali
authors.forename: P S
authors.initials: PS
authors.lastname: Amenta
authors.forename: R M
authors.initials: RM
authors.lastname: Starke
authors.forename: P M
authors.initials: PM
authors.lastname: Jabbour
authors.forename: L F
authors.initials: LF
authors.lastname: Gonzalez
authors.forename: S I
authors.initials: SI
authors.lastname: Tjoumakaris
authors.forename: A E
authors.initials: AE
authors.lastname: Flanders
authors.forename: R H
authors.initials: RH
authors.lastname: Rosenwasser
authors.forename: A S
authors.initials: AS
authors.lastname: Dumont
mesh_terms: D000328:Adult; D002545:Brain Ischemia / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002648:Child; D057510:Endovascular Procedures / Q000592:standards / Q000639:trends*; D006801:Humans; D019635:Neurosurgical Procedures / Q000592:standards / Q000639:trends*; D015607:Stents; D020217:Vertebral Artery Dissection / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*