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Headache in cervicocerebral artery dissection.

Simone Vidale1

  • 1Department of Neurology, Infermi Hospital, Viale Luigi Settembrini, Rimini, Italy. simone.vidale@auslromagna.it.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|August 28, 2020
PubMed
Summary

Cervicocerebral artery dissection (CAD) is a common cause of stroke in young adults, often presenting with severe headaches. Prompt diagnosis via imaging and treatment with anticoagulants are crucial for managing this condition.

Keywords:
Cervical arteryDissectionHeadacheIntracranial arteryMigraine

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Area of Science:

  • Neurology
  • Vascular Medicine

Background:

  • Cervicocerebral artery dissection (CAD) is a significant cause of stroke in young adults, accounting for up to 25% of cases.
  • Etiological classification distinguishes between traumatic and spontaneous CAD based on preceding trauma.
  • Headache is a primary symptom, linked to neuroinflammation near the injured vessel.

Purpose of the Study:

  • To systematically review the literature on cervicocerebral artery dissection (CAD).
  • To analyze the prevalence, characteristics, and clinical presentation of headache in CAD patients.
  • To emphasize the importance of prompt diagnosis and treatment of CAD.

Main Methods:

  • Systematic review of existing literature on cervicocerebral artery dissection.
  • Analysis of reported symptoms, focusing on headache characteristics and prevalence.
  • Review of diagnostic modalities and treatment strategies for CAD.

Main Results:

  • Headache is reported in over 70% of CAD cases, particularly prevalent in vertebrobasilar dissections.
  • More than half of patients experience severe headache, with location varying by circulation (fronto-temporal for anterior, occipito-nuchal for posterior).
  • Headache associated with CAD often presents with other signs of dissection or cerebral ischemia.

Conclusions:

  • Cervicocerebral artery dissection (CAD) frequently presents with severe headache, necessitating specific diagnostic criteria.
  • Prompt diagnosis using MRI or CTA is essential due to the high risk of stroke.
  • Anticoagulant or antithrombotic therapy is the recommended treatment for CAD.