UMEM Educational Pearls

Category: Neurology

Title: Carotid Artery Dissection and Stroke

Keywords: carotid artery dissection, stroke (PubMed Search)

Posted: 1/3/2008 by Aisha Liferidge, MD (Updated: 4/25/2024)
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Consider cervical artery dissection as the source of stroke in patients younger than age 40.
About 20% of such strokes are due to carotid artery or vertebral artery dissections.
Of these, internal carotid artery dissections are the most common.
These patients often present with a triad of neck and head pain, Horner's syndrome, and pulsatile tinnitus.
MRI/MRA is the best non-invasive diagnostic modality for arterial dissection. Angiography may needed for confirmation.

Selim M, Caplan LR. Carotid Artery Dissection. Current Treatment Options Cardiovascular Medicine. 2004; 6: 249-253.

Stapf C, Elkind MS, Mohr JP. Carotid Artery Dissection. Annual Review Medicine. 2000; 51: 329-47.

Schievink W. Spontatneous Dissection of the Carotid and Vertebral arteries. NEJM. 2001; 344: 898-906.