Current Treatment Options in Neurology

, Volume 3, Issue 5, pp 463–469 | Cite as

Spontaneous arterial dissection

  • Tobias Brandt
  • Louis Caplan
Article

Opinion statement

  • There is no controlled study for the best treatment or management of cervicocerebral artery dissection (CAD).

  • Rationale initial empiric treatment in acute CAD to prevent secondary embolism is partial thromboplastin time (PTT)-guided anticoagulation by intravenous heparin followed by anticoagulation with warfarin.

  • Carotid surgery for treatment of CAD is not recommended anymore with the possible exception of persisting severe stenosis of the proximal internal carotid artery (ICA).

  • There could be use of carotid angioplasty by balloon dilatation and stenting in selected cases of severe cerebral hemodynamic impairment by bilateral CAD.

  • Duration of secondary prophylaxis by anticoagulation is best guided by Doppler sonography follow-up, and should be continued until normalization of blood flow or until at least 1 year after the vessel is occluded.

  • There is no evidence that pseudoaneurysms increase the risk for embolic complication, and there is no evidence for surgery or continuation of anticoagulation in patients with pseudoaneurysms.

  • Caution should be recommended for exercises that involve excessive head movements (eg, bungee jumping, trampoline jumping, and chiropractic maneuvers).

  • The patient should be informed that recurrent rate is low in nonfamilial cases.

  • Doppler sonography is a low-cost and high-sensitivity method for patients at risk.

Keywords

Main Drug Interaction Artery Dissection Vertebral Artery Dissection Carotid Artery Dissection Cervical Artery Dissection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Copyright information

© Current Science Inc. 2001

Authors and Affiliations

  • Tobias Brandt
    • 1
  • Louis Caplan
  1. 1.Department of NeurologyUniversity of HeidelbergHeidelbergGermany

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