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Cerebrovascular arterial dissection in children and young adults
1Department of Child Neurology, University of South Alabama College of Medicine, Mobile, USA.
Insights
Cervical and intracranial artery dissections can occur spontaneously or with trauma. Differentiating extracranial from intracranial dissections is key for prognosis, with a need for more research on pediatric and young adult treatments.
Area of Science:
- Neurology
- Vascular Surgery
- Pediatric Neurology
Background:
- Cervical and intracranial artery dissections are significant vascular events.
- These dissections can be spontaneous or associated with trauma and risk factors.
- Extracranial and intracranial dissections present differently and have distinct prognoses.
Purpose of the Study:
- To highlight the importance of recognizing cervical and intracranial artery dissections.
- To differentiate between extracranial and intracranial arterial dissections.
- To address the limited data on treating dissections in pediatric and young adult populations.
Main Methods:
- Review of existing literature on carotid and vertebrobasilar artery dissections.
- Comparison of presentation and prognosis between extracranial and intracranial dissections.
- Exploration of potential therapeutic approaches, including interventional neuroradiology.
Main Results:
- Dissections of cervical and intracranial arteries require prompt diagnosis and management.
- Significant differences exist in the clinical presentation and outcomes of extracranial versus intracranial dissections.
- Current data on optimal medical treatment for dissections in children and young adults are limited.
Conclusions:
- Early recognition and appropriate management are crucial for patients with artery dissections.
- Further research is needed to establish the most effective treatments, particularly for younger populations.
- A multicenter controlled clinical trial is essential to determine optimal therapeutic strategies.
Abstract:
Dissection of the cervical and intracranial portions of the carotid and vertebrobasilar arteries may occur spontaneously or in association with trauma or other underlying risk factors. Astute recognition allows appropriate diagnostic and therapeutic protocols to be instituted. Dissection of extracranial carotid and vertebral arteries differ from their intracranial counterparts, both in terms of presentation and prognosis. Limited data are available regarding the most effective medical treatment of dissection in children and young adults. Interventional neuroradiology may offer a new approach in difficult cases. A multicenter controlled clinical trial is needed to assess the most effective treatment.