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Published on: August 12, 2025

An analysis of the etiology of cervical artery dissections: 1994 to 2003

Michael T Haneline1, Gary N Lewkovich

  • 1Palmer College of Chiropractic West, San Jose, CA 95134, USA. michael.haneline@palmer.edu

Journal of Manipulative and Physiological Therapeutics
|October 18, 2005
PubMed

Insights

Most cervical artery dissections (CAD) are spontaneous, with some linked to trauma. A small percentage of CAD cases are associated with cervical spine manipulation, a finding consistent across studies.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Epidemiology

Background:

  • Cervical artery dissection (CAD) is a significant cause of stroke in younger adults.
  • Understanding the etiology of CAD is crucial for prevention and management strategies.

Purpose of the Study:

  • To conduct a literature review on the etiologic breakdown of cervical artery dissections.
  • To analyze the causes of internal carotid artery dissection and vertebral artery dissection.

Main Methods:

  • A comprehensive literature search of the MEDLINE database was performed for English-language articles.
  • Studies published between 1994 and 2003 were included if they reported at least 5 CAD cases and provided etiological information.

Main Results:

  • Out of 1014 identified citations, 20 met the inclusion criteria, encompassing 606 CAD cases.
  • The majority of CAD cases (61%) were spontaneous, 30% were linked to trauma, and 9% to cervical spinal manipulation.
  • Excluding a potentially biased study reduced the association with cervical spinal manipulation to approximately 6%.

Conclusions:

  • Most cervical artery dissections reviewed were spontaneous.
  • Trauma/trivial trauma was associated with a significant portion of CAD cases.
  • A minority of CAD cases were linked to cervical spine manipulation, aligning with existing literature.
Abstract

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