title: Symptomatogenic acute cervical artery dissection following dental procedure - Case series.
abstract: BACKGROUND
  Cervical artery dissection (CAD) is an important cause of ischemic stroke which may occur following minor traumatic neck manipulations or hyperextension. This paper describes four cases of CAD secondary to dental procedures.
  
  
  METHODS
  Four patients were admitted to the neurology department due to various neurological deficits, which developed subsequently to dental procedure. CT angiography demonstrated CAD in all patients. No predisposing background disease or other neck manipulations were found.
  
  
  CONCLUSIONS
  We describe four cases of dental procedure induced CAD. Since dental procedures are very common, CAD incidence may be higher than recognized. High clinical suspicion is crucial for promoting vascular imaging and diagnosis, especially among patients with non-neurologically symptomatic CAD. We suggest avoiding prolonged neck hyperextension during dental procedures, especially under general anesthesia, in order to prevent this rare but dramatic complication.
authors.affiliation: Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors.forename: J A
authors.initials: JA
authors.lastname: Molad
authors.affiliation: Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Findler
authors.affiliation: Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: N M
authors.initials: NM
authors.lastname: Bornstein
authors.affiliation: Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address: eitanman1@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Auriel
mesh_terms: D000368:Aged; D020215:Carotid Artery, Internal, Dissection / Q000175:diagnosis; D020214:Cerebrovascular Trauma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D003793:Dental Restoration, Permanent / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000098:blood supply* / Q000000981:diagnostic imaging; D019647:Oral Surgical Procedures / Q000009:adverse effects*; D011446:Prospective Studies; D014081:Tooth Extraction / Q000009:adverse effects; D014180:Transplantation / Q000009:adverse effects
keywords: Cervical artery dissection; Stroke