cervical artery dissection: quick review

CAROTID (AND VERTEBRAL) DISSECTIONS: QUICK HITS


--first consult call to Neurologists (less commonly Vascular Surgeons)


--Vascular imaging is a must, but CTA is more sensitive than MRA.  


--To catch on MRI, specific sequences are required so check with your Neurologist/Radiologist to figure out which.  


--Dissections that extend intracranially have a high incidence of forming SAH, especially when heparin is started, thus making heparin have higher mortality than anti-platelet drugs.  


--Extracranial dissections are usually treated with antiplatelet drugs and anticoagulation. 

Submitted by T. Boyd.



Reference(s): Shea et al. Carotid and Vertebral Artery Dissections in the Emergency Department. Emergency Medicine Practice.14;4. April 2012; picture