Cervical artery dissections (CeAD) include both internal carotid and vertebral artery dissections. They are rare but important causes of stroke, especially in younger patients. CeAD should be considered in patients with strokelike symptoms, a new-onset headache and/or neck pain, and/or other risk factors. Early imaging with computed tomography (CT) or magnetic resonance imaging (MRI) is key to making the diagnosis. Treatment may vary depending on the extent of the dissection, timing of the dissection, and other comorbidities. The overall prognosis is good, but does depend on the initial severity of symptoms.
Key points
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Cervical artery dissections (CeAD) are rare but important causes of stroke, especially in the younger population.
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Consider CeAD in patients with new-onset headache and neck pain with or without strokelike symptoms.
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Imaging is key to diagnosis, with several options available.
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Management involves treating acute stroke with thrombolysis or surgical therapy for eligible candidates. All others may be candidates for anticoagulation or antiplatelet therapy to reduce the risk of potential or worsening stroke symptoms. Either agent may be used.
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Prognosis remains good with low morbidity and mortality rates.
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