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Cervical Artery Dissection: A Review of the Epidemiology, Pathophysiology, Treatment, and Outcome

Christina A Blum1, Shadi Yaghi2

  • 1University of Pennsylvania Health System, Department of Neurology, Stroke division.

Archives of Neuroscience
|October 20, 2015
PubMed

Insights

Cervical artery dissection (CAD) is a leading cause of stroke in young adults. Current evidence does not show a difference between anticoagulation and antiplatelet therapy for stroke prevention in CAD patients.

Area of Science:

  • Neurology
  • Vascular Medicine

Background:

  • Cervical artery dissection (CAD) is a significant cause of stroke, particularly in young adults.
  • The optimal antithrombotic treatment for CAD remains controversial, with ongoing debate regarding anticoagulation versus antiplatelet therapy.
  • Existing meta-analyses have not demonstrated a significant difference in stroke prevention between these two treatment modalities.

Purpose of the Study:

  • To review the current understanding of cervical artery dissection, including its mechanisms, clinical presentation, and management.
  • To synthesize evidence regarding the efficacy of anticoagulation versus antiplatelet therapy in preventing stroke in CAD patients.

Main Methods:

  • A comprehensive PubMed search was conducted for articles published between January 1, 1990, and July 1, 2015.
  • Keywords included "Cervical artery dissection", "Dissection", "Carotid dissection", and "Vertebral dissection".
  • Evidence-based peer-reviewed articles, encompassing randomized trials, case series, case reports, and retrospective reviews, were identified and analyzed.

Main Results:

  • The review highlights the underlying mechanisms of cervical artery dissection and associated stroke.
  • It also provides insights into the natural history and current treatment strategies for CAD.
  • The paper underscores the lack of demonstrated superiority of one antithrombotic treatment over the other in preventing stroke.

Conclusions:

  • Multicenter studies and international collaboration are essential due to the rarity of cervical artery dissection.
  • Randomized controlled trials are needed to definitively compare anticoagulation and antiplatelet therapy in CAD patients.
  • Such collaborative efforts will facilitate robust evidence generation for optimal patient management.
Abstract

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