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Vertebral artery dissections

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Pathology and surgery around the vertebral artery

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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.

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  1. M. Arnold
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  2. U. Fischer
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  3. M.-G. Bousser
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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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