Cervical artery dissection

Cervical artery dissection (CAD) is a significant medical condition characterized by a tear in one of the cervical arteries that supply blood to the brain. This tear allows blood to enter the arterial wall and form a blood clot, potentially leading to a stroke. CAD can affect either the carotid or vertebral arteries and is a major cause of strokes in younger and middle-aged adults. This article provides a comprehensive overview of cervical artery dissection, including its symptoms, causes, diagnosis, treatment, and prognosis.

Symptoms

Symptoms of cervical artery dissection vary depending on the artery affected (carotid or vertebral) but may include:

• Sudden, severe headache
• Neck pain
• Partial facial paralysis (Horner's syndrome)
• Vision disturbances
• Pulsatile tinnitus
• Ischemic stroke symptoms, such as weakness or numbness on one side of the body, difficulty speaking, and dizziness

Causes

The exact cause of cervical artery dissection is not fully understood, but it is believed to result from a combination of factors, including:

• Minor neck trauma or injury
• Sudden neck movements
• Genetic predisposition
• Underlying connective tissue disorders, such as Marfan syndrome or Ehlers-Danlos syndrome
• Hypertension
• Infection

Diagnosis

Diagnosis of cervical artery dissection involves a combination of clinical assessment and imaging studies. Imaging techniques used to diagnose CAD include:

• Magnetic Resonance Imaging (MRI)
• Magnetic Resonance Angiography (MRA)
• Computed Tomography Angiography (CTA)
• Doppler ultrasound

Treatment

Treatment for cervical artery dissection aims to prevent stroke and may include:

• Antiplatelet drugs, such as aspirin
• Anticoagulants, such as warfarin
• Thrombolytic therapy in acute stroke settings
• In some cases, surgical intervention or stenting may be necessary

Prognosis

The prognosis for individuals with cervical artery dissection varies. While many patients recover with minimal or no neurological deficits, some may suffer from permanent neurological damage or recurrent strokes. Early diagnosis and treatment are crucial for improving outcomes.

Prevention

Preventive measures for cervical artery dissection are limited but may include:

• Avoiding activities that involve sudden neck movements or trauma
• Managing risk factors, such as hypertension
• Regular monitoring and treatment for individuals with connective tissue disorders