Carotid Artery Dissection

Carotid artery dissection (CAD) is a diverse clinical condition; patients have variable presentations, broad predisposing factors, and varying severity. Patients with CAD can present with head, face, or neck pain; partial Horner syndrome; focal neurological deficits related to cerebral or retinal ischemia; or no symptoms. Urgent management is essential, including administration of anticoagulant or antiplatelet agents to reduce the risk of thromboembolic complications. Patients with recurrent cerebral ischemic events or symptomatic hemodynamic insufficiency from flow-limiting stenosis should consider endovascular intervention. CAD patients with contraindications to antithrombotic medications may require surgical treatment. Medical therapy provides an excellent first-line management strategy for minimizing the thromboembolic stroke risk in CAD patients.