Diagnosis and treatment of arterial dissections

Ricky Medel, Robert M. Starke, Edison P. Valle-Giler, Sheryl Martin-Schild, Ramy El Khoury, Aaron S. Dumont

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

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.

Original languageEnglish (US)
Article number419
JournalCurrent neurology and neuroscience reports
Volume14
Issue number1
DOIs
StatePublished - Jan 2014
Externally publishedYes

Keywords

  • Anticoagulation
  • Antiplatelet
  • Carotid artery
  • Dissection
  • SAH
  • Stroke
  • TIA
  • Trauma
  • Vertebral artery

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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