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Cervical Artery Dissections: Etiopathogenesis and Management
Zafer Keser1, Chia-Chun Chiang1, John C Benson2
1Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Vascular Health and Risk Management
|September 9, 2022
Summary
Cervical artery dissection (CeAD) is a common cause of stroke in young adults, presenting with pain and potential neurological deficits. Management involves controversial treatments, but many patients achieve good recovery with low mortality.
Area of Science:
- Neurology
- Vascular Medicine
- Genetics
Background:
- Cervical Artery Dissection (CeAD) is a significant cause of stroke in individuals under 50.
- Common complications include headache, neck pain, TIA/ischemic stroke, and Horner's syndrome.
- Genetic predisposition and environmental triggers are hypothesized in spontaneous CeAD (sCeAD) pathogenesis.
Purpose of the Study:
- To provide a comprehensive, updated review of CeAD.
- To emphasize the etiopathogenesis and management strategies for CeAD.
- To consolidate current knowledge on CeAD for clinicians and researchers.
Main Methods:
- Literature review of recent studies on CeAD.
- Synthesis of data on CeAD prevalence, complications, and risk factors.
- Analysis of current treatment controversies and outcomes in CeAD.
Main Results:
- CeAD frequently causes stroke in young adults, with headache and neurological deficits as primary complications.
- Over 75% of CeAD cases show arterial occlusion or stenosis, with many experiencing healing, particularly in carotid arteries.
- Dissecting pseudoaneurysms are common but benign; recurrent CeAD risk is low (3-9%), associated with specific genetic and connective tissue disorders.
Conclusions:
- CeAD management, including stroke prevention and headache treatment, requires individualized approaches.
- While complications can be severe, many CeAD patients experience good recovery with low mortality.
- Understanding genetic factors and risk factors like connective tissue disorders is crucial for managing recurrent CeAD.
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