3 Interesting Facts of Cervical artery dissection
- Cervical artery dissection is a major cause of ischemic stroke in young adults, often precipitated by trauma, neck hyperextension, or neck rotation
- Cervical artery (carotid or vertebral) dissections result either from an intimal tear or from direct bleeding within the arterial wall due to ruptured vasa vasorum
- Internal carotid artery dissections present with a classic triad: ipsilateral headache, partial Horner syndrome, and ischemic symptoms (ie, transient ischemic attack, transient monocular blindness, ischemic stroke)
- Vertebral artery dissections are associated with posterior neck pain and posterior cerebral or brainstem ischemia
- Arterial dissection is differentiated from moyamoya arteriopathy based on imaging study findings
- On MRI, dissection is seen as a hyperintense, crescent-shaped wall hematoma and an eccentric flow void of the patent lumen
- On magnetic resonance angiography, axial T1 images through the vessel lumen may show a crescent sign (ie, elliptical bright signal within a vessel wall that surrounds a signal flow void)
- On digital subtraction angiography, dissection is seen as a string sign (ie, a smooth tapered luminal narrowing), an intimal flap, or double-barrel lumen
- Characteristic puff of smoke appearance of moyamoya is not seen in arterial dissections
