II. Pathophysiology
- Most common Cervical Artery Dissection is of the Carotid Artery at 2-3 cm above Carotid Artery bifurcation
- Extracranial Internal Carotid Artery crosses over anterior Cervical Spine at C2-C3, at 2-3 cm above bifurcation
III. Causes
IV. Findings
- Initial
- Ipsilateral Neck Pain
- Often present at onset
- Headache (most common)
- Sudden onset, unilateral, constant, throbbing Headache
- Thunderclap Headache may be present
- Horner Syndrome
- Typically partial Horner Syndrome (Miosis and Ptosis without Anhidrosis)
- Ipsilateral Neck Pain
- Next
- Anterior cerebral ischemia
- Retinal ischemia
- Associated findings
- Carotid Bruit
- Focal neurologic deficits
- Often insidious or subtle developing over days to weeks
V. Complications
- Anterior circulation Cerebrovascular Accident
- Expanding Hematoma
- Arterial Hemorrhage
- Aneurysm formation
- Local mass effect (esp. compression of CN 9, CN 10 and CN 12)
- Subarachnoid Hemorrhage
VI. Imaging
VII. Management
VIII. References
- Hussein and Leiman (2022) Crit Dec Emerg Med 36(8): 4-8
- Blum (2015) Arch Neurosci 2(4) +PMID:26478890 [PubMed]