Current Neurology and Neuroscience Reports

, 14:419

Diagnosis and Treatment of Arterial Dissections

  • Ricky Medel
  • Robert M. Starke
  • Edison P. Valle-Giler
  • Sheryl Martin-Schild
  • Ramy El Khoury
  • Aaron S. Dumont
Stroke (H Adams, Section Editor)

DOI: 10.1007/s11910-013-0419-3

Cite this article as:
Medel, R., Starke, R.M., Valle-Giler, E.P. et al. Curr Neurol Neurosci Rep (2014) 14: 419. doi:10.1007/s11910-013-0419-3
Part of the following topical collections:
  1. Topical Collection on Stroke

Abstract

Dissections of the cervical and intracranial vessels represent an important source of stroke in those less than 50 years of age. This can occur spontaneously or following trauma, minor or major. Rapid diagnosis is essential to limit subsequent sequelae and modern computed tomographic angiography represents an appropriately sensitive modality. Treatment must be individualized to the patient and can consist of an antiplatelet regimen, anticoagulation, or endovascular intervention. No evidence demonstrates superiority of either medical modality and even aspirin alone may be efficacious. Consideration should be given to this in the multi-trauma population in which more aggressive anticoagulation is contraindicated. In addition, thrombolytic administration should not be withheld would it otherwise be indicated. Endovascular intervention is reserved for those with hemodynamically significant narrowing, enlarging pseudoaneurysms, fistulas formation, or subarachnoid hemorrhage.

Keywords

Carotid arteryDissectionVertebral arteryStrokeTIASAHTraumaAnticoagulationAntiplatelet

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Ricky Medel
    • 1
  • Robert M. Starke
    • 2
  • Edison P. Valle-Giler
    • 1
  • Sheryl Martin-Schild
    • 3
  • Ramy El Khoury
    • 3
  • Aaron S. Dumont
    • 1
  1. 1.Department of NeurosurgeryTulane University School of MedicineNew OrleansUSA
  2. 2.Department of NeurosurgeryUniversity of Virginia School of MedicineCharlottesvilleUSA
  3. 3.Department of NeurologyTulane University School of MedicineNew OrleansUSA