Cervicocerebral artery dissections. Issue 6 (1st November 1999)

• Record Type: Journal Article
• Authors: Ahmad, H A; Gerraty, R P; Davis, S M; Cameron, P A
• Is Part Of: Journal of accident & emergency medicine. Volume 16:Issue 6(1999)
• Page Start: 422
• Page End: 424
• Publication Date: 1999-11-01
• Subjects: Emergency medicine -- Periodicals; 616.025
• DOI: 10.1136/emj.16.6.422
• Languages: English
• ISSNs: 2633-6138

Abstract

Abstract : OBJECTIVE: To determine the aetiology, frequency, presentation, and outcome of blunt cervicocerebral arterial dissection presentations. PATIENTS AND METHODS: Cases were retrospectively identified through the stroke registers at Royal Melbourne Hospital (a tertiary teaching hospital) and Geelong Hospital (a regional referral centre). Medical notes were then reviewed. RESULTS: A total of 18 cases were identified, with ages ranging from 28 to 53 years. Fifty five per cent of the injuries sustained were to the internal carotid artery and 45% to the vertebral artery. The majority of the injuries were either spontaneous or associated with trivial forces. Other causes included motor vehicle accidents, falls, and cervical manipulations. Fifty five per cent of patients complained of significant neck pain before presentation. Most patients had delayed presentations, with only 39% presenting on the day of the incident. Seventy eight per cent presented with a neurological deficit. Initial computed tomography was normal in 71% of patients. The majority of patients were managed with anticoagulation, and had minimal functional deficit on discharge. Other treatment modalities included surgery (one patient) and thrombolysis (two patients). One patient was managed conservatively. CONCLUSIONS: The incidence of blunt cervicocerebral arterial dissection is unknown; however it is an uncommon diagnosis. The most common presentation is that of a delayed neurological event. Initial brain computed tomography is usually normal. Minimal adverse outcomes at discharge were noted in patients treated with anticoagulation only.