[Cervical and intracranial artery dissections].

Area of Science:

• Neurology
• Vascular Medicine
• Radiology

Context:

• Cervical and intracranial artery dissections are a significant cause of ischemic stroke, particularly in young adults.
• The precise pathophysiology involves intramural hematoma formation, likely triggered by environmental factors interacting with underlying arteriopathy.
• Clinical presentation often includes headache or neck pain, potentially with local neurological signs, following minor trauma.

Purpose:

• To elucidate the causes, presentation, diagnosis, and management of cervical and intracranial artery dissections.
• To summarize current understanding of the pathophysiology of arterial dissection.
• To outline diagnostic imaging modalities and treatment strategies for arterial dissection.

Summary:

• Arterial dissection originates from intramural hematoma, leading to ischemic stroke. Diagnosis is confirmed via CT-scan or MRI with angiogram.
• Current acute treatment relies on antithrombotics, with intravenous thrombolysis recommended for acute stroke.
• While pathophysiology is not fully understood, it likely involves environmental triggers and arteriopathy. Outcomes are generally favorable, dependent on infarct severity, with rare recurrences.

Impact:

• Improves understanding of a critical cause of stroke in young individuals.
• Highlights the importance of prompt diagnosis and appropriate management of arterial dissections.
• Provides a concise overview for clinicians and researchers regarding current knowledge and treatment of arterial dissection.