Abstract
Vertebral artery dissections (VAD) and internal carotid artery dissections (ICAD) are potentially disabling and yet probably underdiagnosed. They mainly seem to affect young and middle-aged people (1). Cervicocerebral artery dissections (CAD) are responsible for 2% of all strokes and transient ischemic attacks (TIAs) and for up to 25% of strokes and TIAs in patients younger than 45 years (2, 3). CAD are more often affecting the extracranial than the intracranial part of the vessels and spontaneous VAD are generally recognized to be less common than ICAD (4–7). However, a recent population-based study showed an increasing incidence of VAD, probably related to a better detection with the use of MRI and MRA (8). In patients with ICAD as well as VAD, local symptoms such as headache or neck pain often precede ischemic symptoms (9–13). Therefore, it is crucial to detect dissections at a stage when local signs are predominant to prevent disabling strokes.
Keywords
- Vertebral Artery
- 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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References
Bogousslavsky J, Despland PA, Regli F (1987) Spontaneous carotid dissection with acute stroke. Arch Neurol 44:137–40.
Leys D, Bandu L, Henon H, et al. (2002) Clinical outcome in 287 consecutive young adults (15 to 45 years) with ischemic stroke. Neurology 59:26–33.
Nedeltchev K, Auf der Maur T, Georgiadis D, et al. (2005) Ischaemic stroke in young adults: predictors of outcome and recurrence. J Neurol Neurosurg Psychiatry 76:191–5.
Hart RG, Easton JD (1983) Dissections of cervical and cerebral arteries. Neurol Clin 1:155–82.
Mokri B, Sundt TM, Houser OW, Piepgras DG (1986) Spontaneous dissection of the cervical internal carotid artery. Ann Neurol 19:126–38.
Mokri B, Houser OW, Sandok BA, Piepgras DG (1988) Spontaneous dissections of the vertebral arteries. Neurology 38:880–5.
Arnold M, Bousser MG, Fahrni G, et al. (2006) Vertebral artery dissection. Presenting findings and predictors of outcome. Stroke 37:2499–503.
Lee VH, Brown RD, Mandrekar JN, Mokri B (2006) Incidence and outcome of cervical artery dissection. A population-based study. Neurology 67:1809–12.
Biousse V, D’Anglejan-Chatillon J, Massiou H, Bousser MG (1994) Head pain in non-traumatic carotid artery dissection: a series of 65 patients. Cephalalgia 14:33–6.
Biousse V, D’Anglejan-Chatillon J, Massiou H, Bousser MG (1995) Time course of symptoms in extracranial carotid artery dissections. A series of 80 patients. Stroke 26:235–9.
Sturzenegger M (1995) Spontaneous internal carotid artery dissection: early diagnosis and management in 44 patients. J Neurol 242:231–8.
Bassetti C, Bogousslavsky J, Eskenasy-Cottier AC, et al. (1994) Spontaneous intracranial dissection in the anterior circulation. Cerebrovasc Dis 4:170–4.
Schievink WI (2001) Spontaneous dissection of the carotid and vertebral arteries. N Engl J Med 344:899–906.
Schievink WI, Mokri B, Whisnant JP (1993) Internal carotid artery dissection in a community. Rochester, Minnesota, 1987–1992. Stroke 24:1678–80.
Giroud M, Fayolle H, Andre N, et al. (1995) Incidence of internal carotid artery dissection in the community of Dijon. J Neurol Neurosurg Psychiatry 57:1443.
Morki B (1997) Spontaneous dissections of internal carotid arteries. Neurologist 3:104–9.
Arnold M, Kappeler L, Georgiadis D, et al. (2006) Gender differences in spontaneous cervical artery dissection. Neurology 67:1050–2.
Chabrier S, Lasjaunias P, Husson B, et al. (2003) Ischaemic stroke from dissection of the craniocervical arteries in childhood: report of 12 patients. Eur J Paediatr Neurol 7:39–42.
Guillon B, Bousser MG (2002) Epidémiologie et physiopathologie des dissections artérielles cervicales spontanées. J Neuroradiol 29:241–9 [in French].
Farrell MA, Gilbert JJ, Kaufmann JCF (1985) Fatal intracranial arterial dissection: clinical pathological correlation. J Neurol Neurosurg Psychiatry 48:111–21.
Mokri B (1990) Traumatic and spontaneous extracranial internal carotid artery dissections. J Neurol 237:356–61.
Caplan LR, Zarins CK, Hemmati M (1985) Spontaneous dissection of the extracranial vertebral arteries. Stroke 16:868–77.
Mas JL, Henin D, Bousser MG, et al. (1989) Dissecting aneurysm of the vertebral artery and cervical manipulation: a case report with autopsy. Neurology 39:512–5.
Rothwell DM, Bondy SJ, Williams JI (2001) Chiropractic manipulation and stroke: a population-based case-control study. Stroke 32:1054–6.
Arnold M, Camus-Jacqmin M, Stapf C, et al. (2008) Postpartum cervicocephalic dissection. Stroke 39:2377–9.
Grau AJ, Brandt T, Buggle F, et al. (1999) Association of cervical artery dissection with recent infection. Arch Neurol 56:851–6.
Guillon B, Berthet K, Benslamia L, et al. (2003) Infection and the risk of spontaneous cervical artery dissection: a case-control study. Stroke 34:79–81.
Schievink WI, Wijdics EFM, Kuiper JD (1988) Seasonal pattern of spontaneous cervical artery dissection. J Neurosurg 89:101–3.
Genius J, Dong-Si T, Grau AP, Lichy C (2005) Postacute C-reactive protein levels are elevated in cervical artery dissection. Stroke 36:e42–4.
Pezzini A, Del Zotto E, Mazziotti G (2006) Thyroid autoimmunity and spontaneous cervical artery dissection. Stroke 37:2375–7.
Guillon B, Peynet J, Bertrand M, et al. (2007) Do extracellular-matrix-regulating enzymes play a role in cervical artery dissection? Cerebrovasc Dis 23:299–303.
Longoni M, Grond-Ginsbach C, Grau AJ, et al. (2006) The ICAM E469K gene polymorphism is a risk factor for spontaneous cervical artery dissection. Neurology 66:1273–5.
Koller P, Cliffe CM, Ridley DJ (1998) Immunosuppressive therapy for peripartum-type spontaneous coronary dissection. Case report and review. Clin Cardiol 21:40–6.
Tzourio C, Benslamia L, Guillon B, et al. (2002) Migraine and the risk of cervical artery dissection: a case-control study. Neurology 59:435–7.
Pezzini A, Grassi M, Del Zotto E, et al. (2007) Migraine mediates the influence of C677T MTHFR genotypes on ischemic stroke risk with a stroke-subtype effect. Stroke 38:3145–51.
Tzourio C, El Amrani M, Robert L, Alperovitch A (2000) Serum elastase activity is elevated in migraine. Ann Neurol 47:648–51.
Kloss M, Wiest T, Hyrenbach S, et al. (2006) MTHFR 677TT genotype increases the risk for cervical artery dissections. J Neurol Neurosurg Psychiatry 77:951–2.
Arauz A, Hoyost, Cantu C, et al. (2007) Mild hyperhomocysteinemia and low folate concentrations as risk factors for cervical arterial dissection. Cerebrovasc Dis 24:210–4.
Pezzini A, Del Zotto E, Archetti S, et al. (2002) Plasma homocysteine concentration, C677T MTHFR genotype, and 844ins68bp CBS genotype in young adults with spontaneous cervical artery dissection and atherothrombotic stroke. Stroke 33:664–9.
Vila N, Millan M, Ferrer X, et al. (2003) Levels of alphal-antitrypsin in plasma and risk of spontaneous cervical artery dissections: a case-control study. Stroke 34:E168–9.
Pezzini A, Caso V, Zanferrari C, et al. (2006) Arterial hypertension as risk factor for cervical artery dissection: a case-control study. J Neurol Neurosurg Psychiatry 77:95–7.
Rubinstein SM, Peerdeman SM, van Tulder MW, et al. (2005) A systematic review of the risk factors for cervical artery dissection. Stroke 76:1575–8.
Schievink WI, Michels W, Piepgras DG (1994) Neurovascular manifestations of heritable connective tissue disorders: a review. Stroke 25:889–906.
Brandt T, Orberk E, Weber R, et al. (2001) Pathogenesis of cervical artery dissections: association with connective tissue abnormalities. Neurology 57:24–30.
Grond-Ginsbach D, Weber R, Haas J, et al. (1999) Mutations in COL5A1 coding sequence are not common in patients with spontaneous cervical artery dissection. Stroke 30:1887–90.
Dittrich R, Heidbreder A, Rohsbach D, et al. (2007) Connective tissue and vascular phenotype in patients with cervical artery dissection. Neurology 68:2120–4.
Sturzenegger M (1995) Spontaneous internal carotid artery dissection: early diagnosis and management in 44 patients. J Neurol 242:231–8.
Ben Hamouda-M’Rad I, Biousse V, Bousser MG, et al. (1995) Internal carotid artery redundancy is significantly associated with dissection. Stroke 26:1962.
Volker W, Besselmann M, Dittrich R, et al. (2005) Generalized arteriopathy in patients with cervical artery dissection. Neurology 64:1508–13.
Lucas C, Lecroart JL, Gautier C, et al. (2004) Impairment of endothelial function in patients with spontaneous cervical artery dissection: evidence for a general arterial wall disease. Cerebrovasc Dis 17:170–4.
Tzourio C, Cohen A, Lamisse N, et al. (1997) Aortic root dilatation in patients with spontaneous cervical artery dissection. Circulation 95:2351–3.
Schievink WI, Mokri B, Piepgras DG (1992) Angiographic frequency of saccular intracranial aneurysms in patients with spontaneous cervical artery dissection. J Neurosurg 76:62–6.
Schievink WI, Mokri B, Piepgras DG, Kuiper JD (1996) Recurrent spontaneous arterial dissections: risk in familial versus nonfamilial disease. Stroke 27:622–4.
Schievink WI, Michels W, Mokri B, et al. (1995) A familial syndrome of arterial dissection with lentiginosis. N Engl J Med 332:576–9.
Schievink WI, Mokri B (1995) Familial aorto-cervicocephalic arterial dissections and congenitally bicuspid aortic valve. Stroke 26:1935–40.
Benninger DH, Georgiadis D, Kremer C, et al. (2004) Mechanism of ischemic infarct in spontaneous carotid dissection. Stroke 35:482–5.
Silbert PL, Mokri B, Schievink WI (1995) Headache and neck pain in spontaneous internal carotid and vertebral artery dissections. Neurology 45:1517–22.
Mas JL, Bousser MG, Hasboun D, Laplane D (1987) Extracranial vertebral arteries dissections: a review of 13 cases. Stroke 18:1037–47.
Sturzenegger M (1994) Headache and neck pain: the warning symptoms of vertebral artery dissection. Headache 34:187–93.
Crum B, Mokri B, Fulgham J (2000) Spinal manifestations of vertebral artery dissection. Neurology 55:304–6.
Arnold M, Bousser MG (2005) Clinical manifestations of vertebral artery dissection. Handbook on cerebral artery dissection. Front Neurol Neurosci. Karger, Basel, p. 77.
Gamier P, Demasles S, Januel AC, Michel D (2004) Intracranial extension of extracranial vertebral artery dissections. A review of 16 cases. Rev Neurol (Paris) 160:679–84.
Yamaura A, Watanabe Y, Saeki N (1990) Dissecting aneurysms of the intracranial vertebral artery. J Neurosurg 72:183–8.
Caplan LR, Baquis GD, Pessin MS, et al. (1988) Dissection of the intracranial vertebral artery. Neurology 38:868–77.
Hosoda K, Fujita S, Kawaguchi T, et al. (1991) Spontaneous dissecting aneurysms of the basilar artery presenting with a subarachnoid hemorrhage. Report of two cases. J Neurosurg 75:628–33.
Hosoya T, Adachi M, Yamaguchi K, et al. (1999) Clinical and neuroradiological features of intracranial vertebrobasilar artery dissection. Stroke 30:1083–90.
Hicks PA, Leavitt JA, Mokri B (1994) Ophthalmic manifestations of vertebral artery dissection. Patients seen at the Mayo Clinic from 1976 to 1992. Ophthalmology 101:1786–92.
Caplan LR, Estol CJ, Massaro AR (2005) Dissection of the posterior cerebral arteries. Arch Neurol 62:1138–43.
Baumgartner RW, Arnold M, Baumgartner I, et al. (2001) Carotid dissection with and without ischemic events: local symptoms and cerebral artery findings. Neurology 57:827–32.
Mas JL, Goeau C, Bousser MG, et al. (1985) Spontaneous dissecting aneurysm of the internal carotid and vertebral arteries. Two cases reports. Stroke 16:125–9.
Dittrich R, Nassenstein J, Bachmann R, et al. (2007) Polyarterial clustered recurrence of cervical artery dissection seems to be the rule. Neurology 69:180–6.
Amarenco P, Seux-Levieil ML, Cohen A, et al. (1996) Carotid artery dissection with renal infarcts. Two cases. Stroke 25:2488–91.
Stanley I, Sharma VK, Tsivgoulis G, et al. (2007) Painless aortic dissections with unusual extension into intracranial internal carotid arteries. Cerebrovasc Dis 24:314–5.
Mascalchi M, Bianchi MC, Mangiafico S, et al. (1997) MRI and MR angiography of vertebral artery dissection. Neuroradiology 39:329–40.
Yang CW, Carr JC, Futterer SF, et al. (2005) Contrast-enhanced MR angiography of the carotid and vertebrobasilar circulations. AJNR 26:2095–101.
Phan T, Huston J, Bernstein MA, et al. (2001) Contrast-enhanced magnetic resonance angiography of the cervical vessels: experience with 422 patients. Stroke 32:2282–6.
Chen CJ, Tseng YC, Lee TH, et al. (2004). Multisection CT angiography compared with catheter angiography in diagnosing vertebral artery dissection. AJNR 25:769–74.
Mas JL, Bogousslavsky J, Bousser MG (1993) Dissection des artères cervicale et cérébrales. In: Bogousslavsky J, Bousser MG, Mas JL (eds) Accidents vasculaires cérébraux, vol. 1. Doin Editeurs, Paris, p. 284–98.
Sturzenegger M, Mattle HP, Rivoir A, et al. (1993) Ultrasound findings in spontaneous extracranial vertebral artery dissection. Stroke 24:1910–21.
Touboul PJ, Mas JL, Bousser MG, Laplane D (1988) Duplex scanning in extracranial vertebral artery dissection. Stroke 18:116–21.
Guillon B, Brunereau L, Biousse V, et al. (1999) Long-term follow-up of aneurysms developed during extracranial internal carotid artery dissection. Neurology 53:117–22.
Benninger DH, Gandjour J, Georgiadis D, et al. (2007) Benign long-term outcome of conservatively treated cervical aneurysms due to carotid dissection. Neurology 69:486–7.
Engelter ST, Brandt T, Debette S, et al. (2007) Antiplatelets versus anticoagulation in cervical artery dissection. Stroke 38:2605–11.
Norris SW, Lyrer PA, Donan GA, Davis SM (2005) Controversies in stroke: anticoagulants in extracranial arterial dissection. Stroke 36:2041–4.
Metso TM, Metso AJ, Helenius J, et al. (2007) Prognosis and safety of anticoagulation in intracranial artery dissections in adults. Stroke 38:1837–42.
Arnold M, Nedeltchev K, Sturzenegger M, et al. (2002) Thrombolysis in patients with acute stroke caused by cervical artery. Arch Neurol 59:549–53.
Georgiadis D, Lanczik O, Schwab S, et al. (2005) IV thrombolysis in patients with acute stroke due to spontaneous carotid dissection. Neurology 64:1612–4.
Müller BT, Luther B, Hort W, et al. (2000) Surgical treatment of 50 carotid dissections: indications and results. J Vasc Surg 31:980–8.
Nedeltchev K, Remonda L, Do DD, et al. (2004) Acute stenting and thromboaspiration in basilar artery occlusions due to embolism from the dominating vertebral artery. Neuroradiology 46:686–91.
Kremer C, Mosso M, Georgiadis D, et al. (2003) Carotid dissection with permanent and transient occlusion or severe stenosis. Long-term outcome. Neurology 60:271–7.
Touzé E, Gauvrit JY, Moulin T, et al. (2003) Multicenter survey on natural history of cervical artery dissection. Risk of stroke and recurrent dissection after a cervical artery dissection: a multicenter study. Neurology 61:1347–51.
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Arnold, M., Fischer, U., Bousser, MG. (2011). Vertebral artery dissections. In: Pathology and surgery around the vertebral artery. Springer, Paris. https://doi.org/10.1007/978-2-287-89787-0_11
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