Cervical Artery Dissection:a Case Report And Literature Review

PurposeThe aim is to discuss the etiology, clinical manifestations, image characterstics and therapy of cervical artery dissection, to improve our knowledge about cervical artery dissection, to decrease the rate of misdiagnose, missed diagnosis and to provide clinical experience for its therapy.MethodsRetrospective analysis of a case of cervical artery dissection diagnosed by DSA.By typing in variable combinations of principal items such as "cervical artery dissection", "dissecting aneurysm", "imaging tests", "antithrombotic therapy", "intravascular therapy" to the Search engines of PubMed and CNKI, we got a quantity of relevant articles, from which we read the abstract or full text of some articles selectively according to its relevance to our demands. Then we overviewed and concluded those articles and by combining with our case we systematically analyze the etiology, clinical manifestations, image characteristics and therapy of cervical artery dissection.ResultsIn this case the patient is 36 years old, adult male, attacked by the cerebral infarction which happened in the left internal carotid artery territory, cerebral MRI shown the left internal carotid artery occlusion, and cerebral DSA shown the original of the left internal carotid artery nearly occlusion, flames sign, diagnosed with left internal carotid artery dissection. The patient received anticoagulation therapy and took cervical CTA after 3 months. The left internal carotid artery recanalized while associated with dissecting aneurysm. The patient continued to receive anticoagulation therapy and took DSA after 3 months. The lesion didn’t have any change. The patient received coil embolization of dissecting aneurysm successfully.ConclusionsCAD is an important cause of ischemic stroke in young and middle-aged patients. The etiology is not clear. Factors Associated With CAD including major and minor cervical trauma, Fibromuscular dysplasia, Infections, hypertension, Hyperhomocysteinemia, Migraine, several hereditary disease. CAD is responsible for local signs via compression of the neighbouring nervous structures or neurological deficits via migration of emboli or significant haemodynamic stenosis. The local signs of CAD include cervical pain, headache, Homer’s syndrome, cranial nerve palsy and tinnitus. The clinical presentation of cerebral ischaemia caused by CAD (transient ischaemic attack or cerebral infarction) does not differ from that of cerebral ischaemia attributable to other factors. CAD has its radiological hallmarks such as a long tapered stenosis, a tapered occlusion, or a dissecting aneurysm, mural haematoma and so on. Digital subtraction angiography is the golden standard of CAD. Treatment for CAD consisted of antithrombotic therapy (including anticoagulation and antiplatelet therapy), intravascular Interventional treatment and surgical treatment. If the CAD patients can be diagnosised timely and receive effective treatment, most patients get good or favorable outcome.