Internal carotid artery dissection (ICAD): Tear in internal carotid artery (ICA) wall allows blood to enter & delaminate wall layers
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Angiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Adam G et al: Standard diffusion-weighted imaging in the brain can detect cervical internal carotid artery dissections. AJNR Am J Neuroradiol. 41(2):318-22, 2020
Popp D et al: Modified split-scan computed tomography (CT) diagnostics of severely injured patients: first results from a level i trauma center using a dedicated head-and-neck CT-angiogram for the detection of cervical artery dissections. J Clin Med. 9(8), 2020
Priyadarshni S et al: Carotid webs: an unusual presentation of fibromuscular dysplasia. Cureus. 12(8):e9549, 2020
Texakalidis P et al: Endovascular reconstruction of extracranial traumatic internal carotid artery dissections: a systematic review. Neurosurg Rev. 43(3):931-40, 2020
Benson JC et al: The chalice sign: characteristic morphology of the cervical carotid bifurcation in patients with Loeys-Dietz syndrome. Clin Neuroradiol. 30(4):713-20, 2019
Chen SY et al: Internal carotid artery dissection causing pulsatile tinnitus. Am J Otolaryngol. 40(1):121-3, 2019
Chengazi HU et al: Pathology of the carotid space. Insights Imaging. 10(1):21, 2019
Gornik HL et al: First International Consensus on the diagnosis and management of fibromuscular dysplasia. Vasc Med. 24(2):164-89, 2019
Hakimi R et al: Imaging of carotid dissection. Curr Pain Headache Rep. 23(1):2, 2019
Huang RJ et al: Simultaneous non-contrast angiography and intraplaque haemorrhage (SNAP) imaging for cervical artery dissections. Clin Radiol. 74(10):817.e1-7, 2019
Kloss M et al: Recurrence of cervical artery dissection: an underestimated risk. Neurology. 90(16):e1372-8, 2018
McNally JS et al: Magnetic Resonance Imaging and Clinical Factors Associated With Ischemic Stroke in Patients Suspected of Cervical Artery Dissection. Stroke. 49(10):2337-44, 2018
Urasyanandana K et al: Treatment outcomes in cerebral artery dissection and literature review. Interv Neuroradiol. 24(3):254-62, 2018
Coppenrath E et al: Clinical significance of intraluminal contrast enhancement in patients with spontaneous cervical artery dissection: a black-blood MRI Study. Rofo. 189(7):624-31, 2017
Kim BJ et al: Vascular tortuosity may be associated with cervical artery dissection. Stroke. 47(10):2548-52, 2016
Paraskevas KI et al: Fate of distal false aneurysms complicating internal carotid artery dissection: a systematic review. Eur J Vasc Endovasc Surg. 52(3):281-6, 2016
Debette S et al: Common variation in PHACTR1 is associated with susceptibility to cervical artery dissection. Nat Genet. 47(1):78-83, 2015
Debette S et al: Association of vascular risk factors with cervical artery dissection and ischemic stroke in young adults. Circulation. 123(14):1537-44, 2011
Debette S et al: Cervical-artery dissections: predisposing factors, diagnosis, and outcome. Lancet Neurol. 8(7):668-78, 2009
Faivre A et al: Internal carotid artery dissection occurring during intensive practice with Wii video sports games. Neurology. 73(15):1242-3, 2009
Georgiadis D et al: Aspirin vs anticoagulation in carotid artery dissection: a study of 298 patients. Neurology. 72(21):1810-5, 2009
Provenzale JM et al: 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. 193(4):1167-74, 2009
Ansari SA et al: Endovascular treatment of distal cervical and intracranial dissections with the neuroform stent. Neurosurgery. 62(3):636-46; discussion 636-46, 2008
Chandra A et al: Spontaneous dissection of the carotid and vertebral arteries: the 10-year UCSD experience. Ann Vasc Surg. 21(2):178-85, 2007
McIntosh A et al: Carotid artery dissection and middle cerebral artery stroke following methamphetamine use. Neurology. 67(12):2259-60, 2006
Wu HC et al: Spontaneous bilateral internal carotid artery dissection with acute stroke in young patients. Eur Neurol. 56(4):230-4, 2006
Biondi A et al: Progressive symptomatic carotid dissection treated with multiple stents. Stroke. 36(9):e80-2, 2005
Edgell RC et al: Endovascular management of spontaneous carotid artery dissection. J Vasc Surg. 42(5):854-60; discussion 860, 2005
Khan AM et al: Chiropractic sympathectomy: carotid artery dissection with oculosympathetic palsy after chiropractic manipulation of the neck. Mt Sinai J Med. 72(3):207-10, 2005
Knibb J et al: Internal carotid artery dissection presenting with ipsilateral tenth and twelfth nerve palsies and apparent mass lesion on MRI. Br J Radiol. 78(931):659-61, 2005
Roz TM et al: Spontaneous dissection of the internal carotid artery manifesting as pain in an endodontically treated molar. J Am Dent Assoc. 136(11):1556-9, 2005
Rubinstein SM et al: A systematic review of the risk factors for cervical artery dissection. Stroke. 36(7):1575-80, 2005
Badawi RA et al: Hiccups and bilateral carotid artery dissection. J R Soc Med. 97(7):331-2, 2004
Benninger DH et al: Mechanism of ischemic infarct in spontaneous carotid dissection. Stroke. 35(2):482-5, 2004
Kono Y et al: Carotid arteries: contrast-enhanced US angiography--preliminary clinical experience. Radiology. 230(2):561-8, 2004
Payton TF et al: Traumatic dissection of the internal carotid artery. Pediatr Emerg Care. 20(1):27-9, 2004
Chen YC et al: Spontaneous common carotid artery dissection: a case report and review of the literature. Eur Neurol. 50(1):58-60, 2003
Dziewas R et al: Cervical artery dissection--clinical features, risk factors, therapy and outcome in 126 patients. J Neurol. 250(10):1179-84, 2003
Irie K et al: Treatment of a spontaneous intracranial dissecting aneurysm with stent-assisted coil embolization. Neuroradiology. 45(11):825-9, 2003
Nadgir RN et al: Simultaneous bilateral internal carotid and vertebral artery dissection following chiropractic manipulation: case report and review of the literature. Neuroradiology. 45(5):311-4, 2003
Wessels T et al: Vocal cord palsy resulting from spontaneous carotid dissection. Laryngoscope. 113(3):537-40, 2003
Logason K et al: Duplex scan findings in patients with spontaneous cervical artery dissections. Eur J Vasc Endovasc Surg. 23(4):295-8, 2002
Zuccoli G et al: Carotid and vertebral artery dissection: Magnetic Resonance findings in 15 cases. Radiol Med (Torino). 104(5-6):466-71, 2002
Brandt T et al: Pathogenesis of cervical artery dissections: association with connective tissue abnormalities. Neurology. 57(1):24-30, 2001
Duncan MA et al: Traumatic bilateral internal carotid artery dissection following airbag deployment in a patient with fibromuscular dysplasia. Br J Anaesth. 85(3):476-8, 2000
Malek AM et al: Endovascular management of extracranial carotid artery dissection achieved using stent angioplasty. AJNR Am J Neuroradiol. 21(7):1280-92, 2000
Muller BT et al: Surgical treatment of 50 carotid dissections: indications and results. J Vasc Surg. 31(5):980-8, 2000
Saito R et al: Combined neuroendovascular stenting and coil embolization for cervical carotid artery dissection causing symptomatic mass effect. Surg Neurol. 53(4):318-22, 2000
Biffl WL et al: Blunt carotid arterial injuries: implications of a new grading scale. J Trauma. 47(5):845-53, 1999
Bousson V et al: Dissections of the internal carotid artery: three-dimensional time-of-flight MR angiography and MR imaging features. AJR Am J Roentgenol. 173(1):139-43, 1999
Nusbaum AO et al: Isolated vagal nerve palsy associated with a dissection of the extracranial internal carotid artery. AJNR Am J Neuroradiol. 19(10):1845-7, 1998
Pica RA Jr et al: Traumatic internal carotid artery dissection presenting as delayed hemilingual paresis. AJNR Am J Neuroradiol. 17(1):86-8, 1996
Provenzale JM: Dissection of the internal carotid and vertebral arteries: imaging features. AJR Am J Roentgenol. 165(5):1099-104, 1995
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Abbreviations
Carotid artery dissection (CAD)
Definitions
Internal carotid artery dissection (ICAD): Tear in internal carotid artery (ICA) wall allows blood to enter & delaminate wall layers
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Angiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Adam G et al: Standard diffusion-weighted imaging in the brain can detect cervical internal carotid artery dissections. AJNR Am J Neuroradiol. 41(2):318-22, 2020
Popp D et al: Modified split-scan computed tomography (CT) diagnostics of severely injured patients: first results from a level i trauma center using a dedicated head-and-neck CT-angiogram for the detection of cervical artery dissections. J Clin Med. 9(8), 2020
Priyadarshni S et al: Carotid webs: an unusual presentation of fibromuscular dysplasia. Cureus. 12(8):e9549, 2020
Texakalidis P et al: Endovascular reconstruction of extracranial traumatic internal carotid artery dissections: a systematic review. Neurosurg Rev. 43(3):931-40, 2020
Benson JC et al: The chalice sign: characteristic morphology of the cervical carotid bifurcation in patients with Loeys-Dietz syndrome. Clin Neuroradiol. 30(4):713-20, 2019
Chen SY et al: Internal carotid artery dissection causing pulsatile tinnitus. Am J Otolaryngol. 40(1):121-3, 2019
Chengazi HU et al: Pathology of the carotid space. Insights Imaging. 10(1):21, 2019
Gornik HL et al: First International Consensus on the diagnosis and management of fibromuscular dysplasia. Vasc Med. 24(2):164-89, 2019
Hakimi R et al: Imaging of carotid dissection. Curr Pain Headache Rep. 23(1):2, 2019
Huang RJ et al: Simultaneous non-contrast angiography and intraplaque haemorrhage (SNAP) imaging for cervical artery dissections. Clin Radiol. 74(10):817.e1-7, 2019
Kloss M et al: Recurrence of cervical artery dissection: an underestimated risk. Neurology. 90(16):e1372-8, 2018
McNally JS et al: Magnetic Resonance Imaging and Clinical Factors Associated With Ischemic Stroke in Patients Suspected of Cervical Artery Dissection. Stroke. 49(10):2337-44, 2018
Urasyanandana K et al: Treatment outcomes in cerebral artery dissection and literature review. Interv Neuroradiol. 24(3):254-62, 2018
Coppenrath E et al: Clinical significance of intraluminal contrast enhancement in patients with spontaneous cervical artery dissection: a black-blood MRI Study. Rofo. 189(7):624-31, 2017
Kim BJ et al: Vascular tortuosity may be associated with cervical artery dissection. Stroke. 47(10):2548-52, 2016
Paraskevas KI et al: Fate of distal false aneurysms complicating internal carotid artery dissection: a systematic review. Eur J Vasc Endovasc Surg. 52(3):281-6, 2016
Debette S et al: Common variation in PHACTR1 is associated with susceptibility to cervical artery dissection. Nat Genet. 47(1):78-83, 2015
Debette S et al: Association of vascular risk factors with cervical artery dissection and ischemic stroke in young adults. Circulation. 123(14):1537-44, 2011
Debette S et al: Cervical-artery dissections: predisposing factors, diagnosis, and outcome. Lancet Neurol. 8(7):668-78, 2009
Faivre A et al: Internal carotid artery dissection occurring during intensive practice with Wii video sports games. Neurology. 73(15):1242-3, 2009
Georgiadis D et al: Aspirin vs anticoagulation in carotid artery dissection: a study of 298 patients. Neurology. 72(21):1810-5, 2009
Provenzale JM et al: 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. 193(4):1167-74, 2009
Ansari SA et al: Endovascular treatment of distal cervical and intracranial dissections with the neuroform stent. Neurosurgery. 62(3):636-46; discussion 636-46, 2008
Chandra A et al: Spontaneous dissection of the carotid and vertebral arteries: the 10-year UCSD experience. Ann Vasc Surg. 21(2):178-85, 2007
McIntosh A et al: Carotid artery dissection and middle cerebral artery stroke following methamphetamine use. Neurology. 67(12):2259-60, 2006
Wu HC et al: Spontaneous bilateral internal carotid artery dissection with acute stroke in young patients. Eur Neurol. 56(4):230-4, 2006
Biondi A et al: Progressive symptomatic carotid dissection treated with multiple stents. Stroke. 36(9):e80-2, 2005
Edgell RC et al: Endovascular management of spontaneous carotid artery dissection. J Vasc Surg. 42(5):854-60; discussion 860, 2005
Khan AM et al: Chiropractic sympathectomy: carotid artery dissection with oculosympathetic palsy after chiropractic manipulation of the neck. Mt Sinai J Med. 72(3):207-10, 2005
Knibb J et al: Internal carotid artery dissection presenting with ipsilateral tenth and twelfth nerve palsies and apparent mass lesion on MRI. Br J Radiol. 78(931):659-61, 2005
Roz TM et al: Spontaneous dissection of the internal carotid artery manifesting as pain in an endodontically treated molar. J Am Dent Assoc. 136(11):1556-9, 2005
Rubinstein SM et al: A systematic review of the risk factors for cervical artery dissection. Stroke. 36(7):1575-80, 2005
Badawi RA et al: Hiccups and bilateral carotid artery dissection. J R Soc Med. 97(7):331-2, 2004
Benninger DH et al: Mechanism of ischemic infarct in spontaneous carotid dissection. Stroke. 35(2):482-5, 2004
Kono Y et al: Carotid arteries: contrast-enhanced US angiography--preliminary clinical experience. Radiology. 230(2):561-8, 2004
Payton TF et al: Traumatic dissection of the internal carotid artery. Pediatr Emerg Care. 20(1):27-9, 2004
Chen YC et al: Spontaneous common carotid artery dissection: a case report and review of the literature. Eur Neurol. 50(1):58-60, 2003
Dziewas R et al: Cervical artery dissection--clinical features, risk factors, therapy and outcome in 126 patients. J Neurol. 250(10):1179-84, 2003
Irie K et al: Treatment of a spontaneous intracranial dissecting aneurysm with stent-assisted coil embolization. Neuroradiology. 45(11):825-9, 2003
Nadgir RN et al: Simultaneous bilateral internal carotid and vertebral artery dissection following chiropractic manipulation: case report and review of the literature. Neuroradiology. 45(5):311-4, 2003
Wessels T et al: Vocal cord palsy resulting from spontaneous carotid dissection. Laryngoscope. 113(3):537-40, 2003
Logason K et al: Duplex scan findings in patients with spontaneous cervical artery dissections. Eur J Vasc Endovasc Surg. 23(4):295-8, 2002
Zuccoli G et al: Carotid and vertebral artery dissection: Magnetic Resonance findings in 15 cases. Radiol Med (Torino). 104(5-6):466-71, 2002
Brandt T et al: Pathogenesis of cervical artery dissections: association with connective tissue abnormalities. Neurology. 57(1):24-30, 2001
Duncan MA et al: Traumatic bilateral internal carotid artery dissection following airbag deployment in a patient with fibromuscular dysplasia. Br J Anaesth. 85(3):476-8, 2000
Malek AM et al: Endovascular management of extracranial carotid artery dissection achieved using stent angioplasty. AJNR Am J Neuroradiol. 21(7):1280-92, 2000
Muller BT et al: Surgical treatment of 50 carotid dissections: indications and results. J Vasc Surg. 31(5):980-8, 2000
Saito R et al: Combined neuroendovascular stenting and coil embolization for cervical carotid artery dissection causing symptomatic mass effect. Surg Neurol. 53(4):318-22, 2000
Biffl WL et al: Blunt carotid arterial injuries: implications of a new grading scale. J Trauma. 47(5):845-53, 1999
Bousson V et al: Dissections of the internal carotid artery: three-dimensional time-of-flight MR angiography and MR imaging features. AJR Am J Roentgenol. 173(1):139-43, 1999
Nusbaum AO et al: Isolated vagal nerve palsy associated with a dissection of the extracranial internal carotid artery. AJNR Am J Neuroradiol. 19(10):1845-7, 1998
Pica RA Jr et al: Traumatic internal carotid artery dissection presenting as delayed hemilingual paresis. AJNR Am J Neuroradiol. 17(1):86-8, 1996
Provenzale JM: Dissection of the internal carotid and vertebral arteries: imaging features. AJR Am J Roentgenol. 165(5):1099-104, 1995
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