What are the features of headaches occurring with cervical artery dissection
The incidence of dissections is 2.6/100,000/year.
Headache or neck pain is the only symptom of spontaneous cervical artery dissection in 8%.
The headache has a thunderclap onset in about 20% of cases. Headache occurs in 60% to 95% of those with internal carotid artery dissection (ICAD) preceding other neurologic symptoms and/or signs by a mean time of 4 days.
The pain of ICAD, which is ipsilateral in 91% of cases, is typically localized to the frontal or temporal area, jaw, ear, and/or orbit and is more often aching than throbbing. A partial Horner’s syndrome occurs in about 25% of cases with ptosis and miosis.
Headache occurs in 70% of those with vertebral artery dissection (VAD) with head or neck pain preceding other neurologic symptoms and/or signs by a mean time of 14.5 hours.
VAD is typically an ipsilateral occipitonuchal throbbing or pressure but can be bilateral.