Cervical artery dissection (CAD): vertebral versus carotid

Evidence-based neurology checklist on cervical artery dissection (cad): vertebral versus carotid: Features more common with carotid dissection Older age More often male gender More frequent headache at presentation Fronto-temporal location of headache Recent infection More severe stroke Horner’s…

Features more common with carotid dissection

  • Older age
  • More often male gender
  • More frequent headache at presentation
  • Fronto-temporal location of headache
  • Recent infection
  • More severe stroke
  • Horner’s syndrome
  • Pulsatile tinnitus
  • Lower cranial nerve lesions: especially hypoglossal
  • Presentation as hemicrania continua
  • More frequent aneurysmal dilatation
  • Worse outcome at 3 months

Features more common with vertebral dissection

References

  1. Debette S, Grond-Ginsbach C, Bodenant M, et al. Differential features of carotid and vertebral artery dissections. The CADISP study. Neurology 2011; 77:1174-1181.
  2. Brilla R, Pawlowski M, Evers S. Hemicrania continua in carotid artery dissection-symptomatic cases or linked pathophysiology? Cephalalgia 2018; 38:402-405. 
  3. Ashkenazi A, Abbas MA, Sharma DK, Silberstein SD. Hemicrania continua-like headache associated with internal carotid artery dissection may respond to indomethacin. Headache 2007; 47:127-130.
  4. Traenka C, Dougoud D, Simonetti BG, et al; CADISP-Plus Study Group. Cervical artery dissection in patients ≥60 years: Often painless, few mechanical triggers. Neurology 2017; 88:1313-1320.  
  5. Lichy C, Metso A, Pezzini A, et al; Cervical Artery Dissection and Ischemic Stroke Patients-Study Group. Predictors of delayed stroke in patients with cervical artery dissection. Int J Stroke 2015; 10:360-363.

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