User:Mr. Ibrahem/Vertebral artery dissection

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Vertebral artery dissection
Other namesVertebral dissection
Arteries of the neck, with arrows indicating the right vertebral artery
SpecialtyCardiology
SymptomsNeck pain, headache, difficulty speaking, difficulty swallowing, poor coordination[1]
ComplicationsStroke, subarachnoid bleed[1]
CausesNeck injury, Ehler's Danlos syndrome[1]
Diagnostic methodCT scan, magnetic resonance angiography, invasive angiography[1]
Differential diagnosisMigraine, stroke, vasculitis, neck sprain[1]
MedicationAspirin, heparin, warfarin[2]
PrognosisMixed[2]
Frequency1 per 100,000 per year[2]

Vertebral artery dissection (VAD) is a flap-like tear of the inner lining of the vertebral artery, which is located in the neck and supplies blood to the brain.[1] Initial symptoms are generally a sudden onset of headache and one sided neck pain.[1] This may be accompanied stroke symptoms such as difficulty speaking, impaired coordination, or double vision.[1] Complications may include subarachnoid bleeding.[1]

They may occur after a physical injury to the neck, such as coughing, traffic collision, strangulation, or chiropractic manipulation, but may also happen spontaneously.[1][2] People with connective tissue disorder, such as Ehlers-Danlos syndrome, are at increased risk.[1] After the tear, blood enters the arterial wall and forms a blood clot, thickening the artery wall and often impeding blood flow.[1] Diagnosis is usually by contrast-enhanced CT or MRI scan.[2][3]

Treatment is usually with either antiplatelet drugs such as aspirin or with anticoagulants such as heparin or warfarin.[2] About 10% of people die at the onset.[1] Of those who survive this initial period, about 75% recover completely or with minimal impact on functioning, with the remainder having more severe disability, and about 2% dying from complications.[2]

Vertebral artery dissection occurs in about 1 per 100,000 people per year.[2] It is less common than carotid artery dissection (dissection of the large arteries in the front of the neck).[2] The two conditions together account for 10–25% of non-bleeding strokes in young and middle-aged people.[2] The condition was first fully described in the 1970s by the Canadian neurologist C. Miller Fisher.[4]

References[edit]

  1. ^ a b c d e f g h i j k l m Britt, TB; Agarwal, S (January 2020). "Vertebral Artery Dissection". PMID 28722857. {{cite journal}}: Cite journal requires |journal= (help)
  2. ^ a b c d e f g h i j Kim YK, Schulman S (April 2009). "Cervical artery dissection: pathology, epidemiology and management". Thromb. Res. 123 (6): 810–21. doi:10.1016/j.thromres.2009.01.013. PMID 19269682.
  3. ^ Debette S, Leys D (July 2009). "Cervical-artery dissections: predisposing factors, diagnosis, and outcome". Lancet Neurol. 8 (7): 668–78. doi:10.1016/S1474-4422(09)70084-5. PMID 19539238.
  4. ^ Campos-Herrera CR, Scaff M, Yamamoto FI, Conforto AB (December 2008). "Spontaneous cervical artery dissection: an update on clinical and diagnostic aspects". Arq Neuropsiquiatr. 66 (4): 922–7. doi:10.1590/S0004-282X2008000600036. PMID 19099146.
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