title: Diagnosis and treatment of cervical artery dissection.
abstract: Cervical artery dissection (CAD) is a major cause of stroke in the young. A mural hematoma is detected in most CAD patients. The intramural blood accumulation should not be considered a reason to withhold intravenous thrombolysis in patients with CAD-related stroke. Because intravenous-thrombolyzed CAD patients might not recover as well as other stroke patients, acute endovascular treatment is an alternative. Regarding the choice of antithrombotic agents, this article discusses the findings of 4 meta-analyses across observational data, the current status of 3 randomized controlled trials, and arguments and counterarguments favoring anticoagulants over antiplatelets. Furthermore, the role of stenting and surgery is addressed.
authors.affiliation: Department of Neurology and Stroke Center, University Hospital Basel, Petersgraben 4, Basel CH - 4031, Switzerland; Neurorehabilitation Unit, Felix Platter Hospital, University Center for Medicine of Aging and Rehabilitation, Burgfelderstrasse 101, Basel CH - 4012, Switzerland. Electronic address: stefan.engelter@usb.ch.
authors.forename: Stefan T
authors.initials: ST
authors.lastname: Engelter
authors.affiliation: Department of Neurology and Stroke Center, University Hospital Basel, Petersgraben 4, Basel CH - 4031, Switzerland.
authors.forename: Christopher
authors.initials: C
authors.lastname: Traenka
authors.affiliation: Department of Radiology, Neuroradiology and Stroke Center, University Hospital Basel, Petersgraben 4, Basel CH - 4031, Switzerland.
authors.forename: Alexander
authors.initials: A
authors.lastname: Von Hessling
authors.affiliation: Department of Neurology and Stroke Center, University Hospital Basel, Petersgraben 4, Basel CH - 4031, Switzerland.
authors.forename: Philippe A
authors.initials: PA
authors.lastname: Lyrer
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis* / Q000628:therapy*; D000925:Anticoagulants / Q000627:therapeutic use; D001158:Arteries / Q000473:pathology; D001921:Brain / Q000098:blood supply*; D057510:Endovascular Procedures; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents
keywords: Anticoagulants; Antipatelets; Cervical artery dissection; Endovascular treatment; IV thrombolysis; Stroke; Surgery