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Vertebral Artery Dissection in Neck
C. Douglas Phillips, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Vertebral artery (VA) dissection
              • Definitions

                • Narrowing &/or occlusion of VA secondary to intimal tear and subadventitial hematoma

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Angiographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Hunter MD et al: Influenza-like illness is associated with increased short-term risk of cervical artery dissection. J Stroke Cerebrovasc Dis. 30(2):105490, 2021
                                          2. Ho AL et al: Predictors of cervical vertebral and carotid artery dissection during blunt trauma: experience from a level 1 trauma center. World Neurosurg. 137:e315-20, 2020
                                          3. Patel P et al: "COVID-19 and cervical artery dissection- a causative association?" J Stroke Cerebrovasc Dis. 29(10):105047, 2020
                                          4. Singh RB et al: Window to the circulatory system: ocular manifestations of cardiovascular diseases. Eur J Ophthalmol. 30(6):1207-19, 2020
                                          5. Wu Y et al: Predisposing factors and radiological features in patients with internal carotid artery dissection or vertebral artery dissection. BMC Neurol. 20(1):445, 2020
                                          6. Ben Hassen W et al: Imaging of cervical artery dissection. Diagn Interv Imaging. 95(12):1151-61, 2014
                                          7. Lum C et al: Vertebral artery dissection with a normal-appearing lumen at multisection CT angiography: the importance of identifying wall hematoma. AJNR Am J Neuroradiol. 30(4):787-92, 2009
                                          8. 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
                                          9. Provenzale JM: MRI and MRA for evaluation of dissection of craniocerebral arteries: lessons from the medical literature. Emerg Radiol. 16(3):185-93, 2009
                                          10. Tan MA et al: Late complications of vertebral artery dissection in children: pseudoaneurysm, thrombosis, and recurrent stroke. J Child Neurol. 24(3):354-60, 2009
                                          11. Hashimoto M et al: Conservative treatment of ruptured vertebrobasilar dissecting aneurysm. Neurol Sci. 29(4):241-4, 2008
                                          12. Rodallec MH et al: Craniocervical arterial dissection: spectrum of imaging findings and differential diagnosis. Radiographics. 28(6):1711-28, 2008
                                          13. Rabinov JD et al: Endovascular management of vertebrobasilar dissecting aneurysms. AJNR Am J Neuroradiol. 24(7): 1421-8, 2003
                                          14. Shin JH et al: Vertebral artery dissection: spectrum of imaging findings with emphasis on angiography and correlation with clinical presentation. Radiographics. 20(6): 1687-96, 2000
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Vertebral artery (VA) dissection
                                                      • Definitions

                                                        • Narrowing &/or occlusion of VA secondary to intimal tear and subadventitial hematoma

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Angiographic Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Gross Pathologic & Surgical Features

                                                                      • Microscopic Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Hunter MD et al: Influenza-like illness is associated with increased short-term risk of cervical artery dissection. J Stroke Cerebrovasc Dis. 30(2):105490, 2021
                                                                                  2. Ho AL et al: Predictors of cervical vertebral and carotid artery dissection during blunt trauma: experience from a level 1 trauma center. World Neurosurg. 137:e315-20, 2020
                                                                                  3. Patel P et al: "COVID-19 and cervical artery dissection- a causative association?" J Stroke Cerebrovasc Dis. 29(10):105047, 2020
                                                                                  4. Singh RB et al: Window to the circulatory system: ocular manifestations of cardiovascular diseases. Eur J Ophthalmol. 30(6):1207-19, 2020
                                                                                  5. Wu Y et al: Predisposing factors and radiological features in patients with internal carotid artery dissection or vertebral artery dissection. BMC Neurol. 20(1):445, 2020
                                                                                  6. Ben Hassen W et al: Imaging of cervical artery dissection. Diagn Interv Imaging. 95(12):1151-61, 2014
                                                                                  7. Lum C et al: Vertebral artery dissection with a normal-appearing lumen at multisection CT angiography: the importance of identifying wall hematoma. AJNR Am J Neuroradiol. 30(4):787-92, 2009
                                                                                  8. 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
                                                                                  9. Provenzale JM: MRI and MRA for evaluation of dissection of craniocerebral arteries: lessons from the medical literature. Emerg Radiol. 16(3):185-93, 2009
                                                                                  10. Tan MA et al: Late complications of vertebral artery dissection in children: pseudoaneurysm, thrombosis, and recurrent stroke. J Child Neurol. 24(3):354-60, 2009
                                                                                  11. Hashimoto M et al: Conservative treatment of ruptured vertebrobasilar dissecting aneurysm. Neurol Sci. 29(4):241-4, 2008
                                                                                  12. Rodallec MH et al: Craniocervical arterial dissection: spectrum of imaging findings and differential diagnosis. Radiographics. 28(6):1711-28, 2008
                                                                                  13. Rabinov JD et al: Endovascular management of vertebrobasilar dissecting aneurysms. AJNR Am J Neuroradiol. 24(7): 1421-8, 2003
                                                                                  14. Shin JH et al: Vertebral artery dissection: spectrum of imaging findings with emphasis on angiography and correlation with clinical presentation. Radiographics. 20(6): 1687-96, 2000