Treatment of cervical artery dissections / 国际脑血管病杂志

ABSTRACT

Cervical artery dissection (CeAD) is an important cause of ischemic stroke in young adults w ith ischemic stroke. The clinical manifestations are often local facial pain, Horner syndrome, and ischemic stroke. With the development of noninvasive imaging, many patients w ith CeAD have got early diagnosis. Thromboembolism is an important mechanism of its pathogenesis. Timely giving anticoagulation therapy is reasonable. How ever, anticoagulants may lead to intramural hematoma expansion; therefore, there are also people w ho support antiplatelet therapy. How ever, the effectiveness of the 2 regimens needs to be confirmed by randomized trials. The recently completed Cervical Artery Dissection in Stroke Study (CADISS) in patients w ith stroke is the first prospective study aiming at the problem. The results have show ed that there w as no significant difference in efficacy betw een the anticoagulants and the antiplatelet drugs. Thrombolysis in patients w ith acute CeAD can not increase the risks of hemorrhage, and the rate of good functional outcome is similar to that of the control group. Therefore, it can be used as a treatment method in acute phase. For patients w hose antithrombotic treatment is invalid or having contraindications and repeated recurrent stroke can conduct endovascular intervention or surgical treatment. Usualy, the prognosis of patients w ith CeAD is better. The stroke recurrence rate is low . The abnormal arterial w als in more than half of the patients w il disappear at 3 to 6 months.