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- Consider cervical artery dissection as the source of stroke in patients younger than age 40.
- About 20% of such strokes are due to carotid artery or vertebral artery dissections.
- Of these, internal carotid artery dissections are the most common.
- These patients often present with a triad of neck and head pain, Horner's syndrome, and pulsatile tinnitus.
- MRI/MRA is the best non-invasive diagnostic modality for arterial dissection. Angiography may needed for confirmation.
Selim M, Caplan LR. Carotid Artery Dissection. Current Treatment Options Cardiovascular Medicine. 2004; 6: 249-253.
Stapf C, Elkind MS, Mohr JP. Carotid Artery Dissection. Annual Review Medicine. 2000; 51: 329-47.
Schievink W. Spontatneous Dissection of the Carotid and Vertebral arteries. NEJM. 2001; 344: 898-906.