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Diagnosis and Treatment of Arterial Dissections

  • Stroke (H Adams, Section Editor)
  • Published:
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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.

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Conflict of Interest

Ricky Medel declares that he has no conflict of interest. Robert M. Starke declares that he has no conflict of interest. Edison P. Valle-Gil declares that he has no conflict of interest. Sheryl Martin-Schild declares that she has no conflict of interest. Ramy El Khoury declares that he has no conflict of interest. Aaron S. Dumont declares that he has no conflict of interest.

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  1. Department of Neurosurgery, Tulane University School of Medicine, 131 S. Robertson St, 8047, New Orleans, LA, 70112, USA

    Ricky Medel, Edison P. Valle-Giler & Aaron S. Dumont

  2. Department of Neurosurgery, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA

    Robert M. Starke

  3. Department of Neurology, Tulane University School of Medicine, New Orleans, LA, 70112, USA

    Sheryl Martin-Schild & Ramy El Khoury

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Correspondence to Aaron S. Dumont.

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Medel, R., Starke, R.M., Valle-Giler, E.P. et al. Diagnosis and Treatment of Arterial Dissections. Curr Neurol Neurosci Rep 14, 419 (2014). https://doi.org/10.1007/s11910-013-0419-3

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