Vertebral Artery Dissection Questions & Answers

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2. Raupp SF, Jellema K, Sluzewski M, de Kort PL, Visser LH. Sudden unilateral deafness due to a right vertebral artery dissection. Neurology. 2004 Apr 27. 62(8):1442. [QxMD MEDLINE Link].

3. Garry D, Forrest-Hay A. A headache not to be sneezed at. Emerg Med J. 2009 May. 26(5):384-5. [QxMD MEDLINE Link].

4. Stahmer SA, Raps EC, Mines DI. Carotid and vertebral artery dissections. Emerg Med Clin North Am. 1997 Aug. 15(3):677-98. [QxMD MEDLINE Link].

5. Lyrer PA, Brandt T, Metso TM, et al. Clinical import of Horner syndrome in internal carotid and vertebral artery dissection. Neurology. 2014 May 6. 82(18):1653-9. [QxMD MEDLINE Link].

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7. Levy C, Laissy JP, Raveau V, et al. Carotid and vertebral artery dissections: three-dimensional time-of-flight MR angiography and MR imaging versus conventional angiography. Radiology. 1994 Jan. 190(1):97-103. [QxMD MEDLINE Link].

8. Provenzale JM, Sarikaya B. Comparison of test performance characteristics of MRI, MR angiography, and CT angiography in the diagnosis of carotid and vertebral artery dissection: a review of the medical literature. AJR Am J Roentgenol. 2009 Oct. 193(4):1167-74. [QxMD MEDLINE Link].

9. Silbert PL, Mokri B, Schievink WI. Headache and neck pain in spontaneous internal carotid and vertebral artery dissections. Neurology. 1995 Aug. 45(8):1517-22. [QxMD MEDLINE Link].

10. Yoshimoto Y, Wakai S. Unruptured intracranial vertebral artery dissection. Clinical course and serial radiographic imagings. Stroke. 1997 Feb. 28(2):370-4. [QxMD MEDLINE Link]. [Full Text].

11. [Guideline] Daffner RH, Hackney DB, Dalinka MK, et al. Suspected spine trauma. [online publication]. Reston (VA): American College of Radiology (ACR). 2007. [Full Text].

12. Grau AJ, Brandt T, Buggle F, et al. Association of cervical artery dissection with recent infection. Arch Neurol. 1999 Jul. 56(7):851-6. [QxMD MEDLINE Link].

13. de Bray JM, Penisson-Besnier I, Dubas F, Emile J. Extracranial and intracranial vertebrobasilar dissections: diagnosis and prognosis. J Neurol Neurosurg Psychiatry. 1997 Jul. 63(1):46-51. [QxMD MEDLINE Link].

14. Beletsky V, Nadareishvili Z, Lynch J, Shuaib A, Woolfenden A, Norris JW. Cervical arterial dissection: time for a therapeutic trial?. Stroke. 2003 Dec. 34(12):2856-60. [QxMD MEDLINE Link]. [Full Text].

15. Norris JW, Beletsky V, Nadareishvili ZG. Sudden neck movement and cervical artery dissection. The Canadian Stroke Consortium. CMAJ. 2000 Jul 11. 163(1):38-40. [QxMD MEDLINE Link].

16. Rubinstein SM, Peerdeman SM, van Tulder MW, Riphagen I, Haldeman S. A systematic review of the risk factors for cervical artery dissection. Stroke. 2005 Jul. 36(7):1575-80. [QxMD MEDLINE Link].

17. Jaffre A, Ruidavets JB, Calviere L, Viguier A, Ferrieres J, Larrue V. Risk factor profile by etiological subtype of ischemic stroke in the young. Clin Neurol Neurosurg. 2014 May. 120:78-83. [QxMD MEDLINE Link].

18. Lleva P, Ahluwalia BS, Marks S, et al. Traumatic and spontaneous carotid and vertebral artery dissection in a level 1 trauma center. J Clin Neurosci. 2012 Aug. 19(8):1112-4. [QxMD MEDLINE Link].

19. Dziewas R, Konrad C, Drager B, et al. Cervical artery dissection--clinical features, risk factors, therapy and outcome in 126 patients. J Neurol. 2003 Oct. 250(10):1179-84. [QxMD MEDLINE Link].

20. Haldeman S, Kohlbeck FJ, McGregor M. Stroke, cerebral artery dissection, and cervical spine manipulation therapy. J Neurol. 2002 Aug. 249(8):1098-104. [QxMD MEDLINE Link].

21. Smith WS, Johnston SC, Skalabrin EJ, et al. Spinal manipulative therapy is an independent risk factor for vertebral artery dissection. Neurology. 2003 May 13. 60(9):1424-8. [QxMD MEDLINE Link].

22. Stevinson C, Honan W, Cooke B, Ernst E. Neurological complications of cervical spine manipulation. J R Soc Med. 2001 Mar. 94(3):107-10. [QxMD MEDLINE Link].

23. [Guideline] Anderson-Peacock E, Blouin JS, Bryans R, et al. Chiropractic clinical practice guideline: evidence-based treatment of adult neck pain not due to whiplash. J Can Chiropr Assoc. 2005 Sep. 49(3):158-209. [QxMD MEDLINE Link]. [Full Text].

24. Zhou M, Zheng H, Gong S, et al. Vertebral artery hypoplasia and vertebral artery dissection: a hospital-based cohort study. Neurology. 2015 Feb 24. 84(8):818-24. [QxMD MEDLINE Link].

25. Pezzini A, Caso V, Zanferrari C, et al. Arterial hypertension as risk factor for spontaneous cervical artery dissection. A case-control study. J Neurol Neurosurg Psychiatry. 2006 Jan. 77(1):95-7. [QxMD MEDLINE Link].

26. Kelly JC, Safain MG, Roguski M, Edlow AG, Malek AM. Postpartum internal carotid and vertebral arterial dissections. Obstet Gynecol. 2014 Apr. 123(4):848-56. [QxMD MEDLINE Link].

27. CADISS trial investigators, Markus HS, Hayter E, Levi C, et al. Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): a randomised trial. Lancet Neurol. 2015 Apr. 14(4):361-7. [QxMD MEDLINE Link].

28. Kennedy F, Lanfranconi S, Hicks C, et al. Antiplatelets vs anticoagulation for dissection: CADISS nonrandomized arm and meta-analysis. Neurology. 2012 Aug 14. 79(7):686-9. [QxMD MEDLINE Link].

29. Fukuhara K, Ogata T, Ouma S, et al. Impact of initial symptom for accurate diagnosis of vertebral artery dissection. Int J Stroke. 2015 Oct. 10 Suppl A100:30-3. [QxMD MEDLINE Link].

30. Kim JG, Choi JY, Kim SU, et al. Headache characteristics of uncomplicated intracranial vertebral artery dissection and validation of ICHD-3 beta diagnostic criteria for headache attributed to intracranial artery dissection. Cephalalgia. 2015 May. 35(6):516-26. [QxMD MEDLINE Link].

31. Thomas LC, Rivett DA, Attia JR, Levi C. Risk factors and clinical presentation of cervical arterial dissection: preliminary results of a prospective case-control study. J Orthop Sports Phys Ther. 2015 Jul. 45(7):503-11. [QxMD MEDLINE Link].

32. Robertson JJ, Koyfman A. Cervical artery dissections: a review. J Emerg Med. 2016 Nov. 51(5):508-18. [QxMD MEDLINE Link].

33. [Guideline] Brott TG, Halperin JL, Abbara S, et al, for the ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology... Vasc Med. 2011 Feb. 16(1):35-77. [QxMD MEDLINE Link]. [Full Text].

34. Long A, Lepoutre A, Corbillon E, Branchereau A. Critical review of non- or minimally invasive methods (duplex ultrasonography, MR- and CT-angiography) for evaluating stenosis of the proximal internal carotid artery. Eur J Vasc Endovasc Surg. 2002 Jul. 24(1):43-52. [QxMD MEDLINE Link].

35. Park KJ, Jung SC, Kim HS, et al. Multi-contrast high-resolution magnetic resonance findings of spontaneous and unruptured intracranial vertebral artery dissection: qualitative and quantitative analysis according to stages. Cerebrovasc Dis. 2016. 42(1-2):23-31. [QxMD MEDLINE Link].

36. Kobayashi H, Morishita T, Ogata T, et al. Extracranial and intracranial vertebral artery dissections: a comparison of clinical findings. J Neurol Sci. 2016 Mar 15. 362:244-50. [QxMD MEDLINE Link].

37. Ben Hassen W, Machet A, Edjlali-Goujon M, et al. Imaging of cervical artery dissection. Diagn Interv Imaging. 2014 Dec. 95(12):1151-61. [QxMD MEDLINE Link].

38. Simonnet H, Deiva K, Bellesme C, et al. Extracranial vertebral artery dissection in children: natural history and management. Neuroradiology. 2015 Jul. 57(7):729-38. [QxMD MEDLINE Link].

39. Lansberg MG, O'Donnell MJ, Khatri P, et al, for the American College of Chest Physicians. Antithrombotic and thrombolytic therapy for ischemic stroke: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb. 141 (2 suppl):e601S-36S. [QxMD MEDLINE Link].

40. Markus HS, Hayter E, Levi C, et al, for the CADISS trial investigators. Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): a randomised trial. Lancet Neurol. 2015 Apr. 14(4):361-7. [QxMD MEDLINE Link].

41. Kennedy F, Lanfranconi S, Hicks C, et al, for the CADISS Investigators. Antiplatelets vs anticoagulation for dissection: CADISS nonrandomized arm and meta-analysis. Neurology. 2012 Aug 14. 79(7):686-9. [QxMD MEDLINE Link].

42. Chowdhury MM, Sabbagh CN, Jackson D, Coughlin PA, Ghosh J. Antithrombotic treatment for acute extracranial carotid artery dissections: a meta-analysis. Eur J Vasc Endovasc Surg. 2015 Aug. 50(2):148-56. [QxMD MEDLINE Link].

43. Nam KH, Ko JK, Cha SH, Choi CH, Lee TH, Lee JI. Endovascular treatment of acute intracranial vertebral artery dissection: long-term follow-up results of internal trapping and reconstructive treatment using coils and stents. J Neurointerv Surg. 2015 Nov. 7(11):829-34. [QxMD MEDLINE Link].

44. Kernan WN, Ovbiagele B, Black HR, et al, for the American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014 Jul. 45(7):2160-236. [QxMD MEDLINE Link].

45. Hernandez-Duran S, Ogilvy CS. Clinical outcomes of patients with vertebral artery dissection treated endovascularly: a meta-analysis. Neurosurg Rev. 2014 Oct. 37(4):569-77. [QxMD MEDLINE Link].

46. Schievink WI. The treatment of spontaneous carotid and vertebral artery dissections. Curr Opin Cardiol. 2000 Sep. 15(5):316-21. [QxMD MEDLINE Link].

47. [Guideline] Adams RJ, Albers G, Alberts MJ, et al. Update to the AHA/ASA recommendations for the prevention of stroke in patients with stroke and transient ischemic attack. Stroke. 2008 May. 39(5):1647-52. [QxMD MEDLINE Link]. [Full Text].

48. [Guideline] Sacco RL, Adams R, Albers G, et al. Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention: the American Academy of Neurology affirms the value of this guideline. Stroke. 2006 Feb. 37(2):577-617. [QxMD MEDLINE Link]. [Full Text].

49. Mustanoja S, Metso TM, Putaala J, et al. Helsinki experience on nonvitamin K oral anticoagulants for treating cervical artery dissection. Brain Behav. 2015 Aug. 5(8):e00349. [QxMD MEDLINE Link].

50. Caprio FZ, Bernstein RA, Alberts MJ, et al. Efficacy and safety of novel oral anticoagulants in patients with cervical artery dissections. Cerebrovasc Dis. 2014. 38(4):247-53. [QxMD MEDLINE Link].

51. Lyrer P, Engelter S. Antithrombotic drugs for carotid artery dissection. Cochrane Database Syst Rev. 2003. (3):CD000255.

52. Caplan LR. Barnett H, ed. Stroke: Pathophysiology, Diagnosis and Management. London, England: Churchill Livingstone; 1986. Vol 1: 549-619.

53. Condie J, Shaibani A, Wainwright MS. Successful treatment of recurrent basilar artery occlusion with intra-arterial thrombolysis and vertebral artery coiling in a child. Neurocrit Care. 2012 Feb. 16(1):158-62. [QxMD MEDLINE Link].

54. De Giorgio F, Vetrugno G, De Mercurio D, et al. Dissection of the vertebral artery during a basketball game: a case report. Med Sci Law. 2004 Jan. 44(1):80-6. [QxMD MEDLINE Link].

55. Hamada J, Kai Y, Morioka M, Yano S, Todaka T, Ushio Y. Multimodal treatment of ruptured dissecting aneurysms of the vertebral artery during the acute stage. J Neurosurg. 2003 Dec. 99(6):960-6. [QxMD MEDLINE Link].

56. Kashiwazaki D, Ushikoshi S, Asano T, Kuroda S, Houkin K. Long-term clinical and radiological results of endovascular internal trapping in vertebral artery dissection. Neuroradiology. 2013 Feb. 55(2):201-6. [QxMD MEDLINE Link].

57. Mokri B. Traumatic and spontaneous extracranial internal carotid artery dissections. J Neurol. 1990 Oct. 237(6):356-61. [QxMD MEDLINE Link].

58. Prabhu V, Kizer J, Patil A, Hellbusch L, Taylon C, Leibrock L. Vertebrobasilar thrombosis associated with nonpenetrating cervical spine trauma. J Trauma. 1996 Jan. 40(1):130-7. [QxMD MEDLINE Link].

59. Provenzale JM, Sarikaya B. Comparison of test performance characteristics of MRI, MR angiography, and CT angiography in the diagnosis of carotid and vertebral artery dissection: a review of the medical literature. AJR Am J Roentgenol. 2009 Oct. 193(4):1167-74. [QxMD MEDLINE Link].

60. Ramphul N, Geary U. Caveats in the management and diagnosis of cerebellar infarct and vertebral artery dissection. Emerg Med J. 2009 Apr. 26(4):303-4. [QxMD MEDLINE Link].

61. Rodallec MH, Marteau V, Gerber S, Desmottes L, Zins M. Craniocervical arterial dissection: spectrum of imaging findings and differential diagnosis. Radiographics. 2008 Oct. 28(6):1711-28. [QxMD MEDLINE Link].

62. Schievink WI. Spontaneous dissection of the carotid and vertebral arteries. N Engl J Med. 2001 Mar 22. 344(12):898-906. [QxMD MEDLINE Link].

63. Sturzenegger M, Mattle HP, Rivoir A, Rihs F, Schmid C. Ultrasound findings in spontaneous extracranial vertebral artery dissection. Stroke. 1993 Dec. 24(12):1910-21. [QxMD MEDLINE Link].

64. Park MS, Albuquerque FC, Nanaszko M, et al. Critical assessment of complications associated with use of the Pipeline Embolization Device. J Neurointerv Surg. 2015 Sep. 7(9):652-9. [QxMD MEDLINE Link].

65. Cohen JE, Gomori JM, Rajz G, Itshayek E, Eichel R, Leker RR. Urgent off-label use of the pipeline flow diverter stent in selected ischemic cerebrovascular conditions: thrombotic segments and tortuous arteries. J Neurointerv Surg. 2015 Sep. 7(9):671-5. [QxMD MEDLINE Link].

66. Robertson JJ, Koyfman A. Extracranial cervical artery dissections. Emerg Med Clin North Am. 2017 Nov. 35(4):727-41. [QxMD MEDLINE Link].

67. Takahara M, Ogata T, Abe H, et al. The comparison of clinical findings and treatment between unilateral and bilateral vertebral artery dissection. J Stroke Cerebrovasc Dis. 2019 Jan 30. [QxMD MEDLINE Link].

68. Hajnovic L, Sefranek V, Schutz L. Trauma of the extracranial cerebral arteries due to injuries of the cervical spine. Rozhl Chir. 2018 Winter. 97(11):504-8. [QxMD MEDLINE Link].

69. MacArthur AM, Mehdi S. Early detection of vertebral artery dissection. BMJ Case Rep. 2018 Nov 28. 11(1):[QxMD MEDLINE Link].

Eddy S Lang, MDCM, CCFP(EM), CSPQ Associate Professor, Senior Researcher, Division of Emergency Medicine, Department of Family Medicine, University of Calgary Faculty of Medicine; Assistant Professor, Department of Family Medicine, McGill University Faculty of Medicine, Canada

Eddy S Lang, MDCM, CCFP(EM), CSPQ is a member of the following medical societies: American College of Emergency Physicians, Society for Academic Emergency Medicine, Canadian Association of Emergency Physicians

Disclosure: Nothing to disclose.

Marc Afilalo, MD, FACEP, FRCPC, MCFP(EM), CSPQ Director, Emergency Department, Associate Professor, Faculty of Medicine, Section of Emergency Medicine, The Sir Mortimer B Davis Jewish General Hospital

Marc Afilalo, MD, FACEP, FRCPC, MCFP(EM), CSPQ is a member of the following medical societies: American College of Emergency Physicians, Royal College of Physicians and Surgeons of Canada, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Inderjeet (Indy) S Sahota, MD, MSc, CCFP Resident Physician, CCFP-EM Emergency Medicine R3, University of British Columbia Faculty of Medicine, Canada

Inderjeet (Indy) S Sahota, MD, MSc, CCFP is a member of the following medical societies: Canadian Association of Emergency Physicians, Canadian Cardiovascular Society, Canadian Medical Association

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Amin Antoine Kazzi, MD Professor of Clinical Emergency Medicine, Department of Emergency Medicine, American University of Beirut, Lebanon

Amin Antoine Kazzi, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Barry E Brenner, MD, PhD, FACEP Program Director, Emergency Medicine, Einstein Medical Center Montgomery

Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, New York Academy of Medicine, New York Academy of Sciences, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Joseph J Sachter, MD, FACEP Consulting Staff, Department of Emergency Medicine, Muhlenberg Regional Medical Center

Joseph J Sachter, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Association for Physician Leadership, American Medical Association, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

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