Craniocervical artery dissection

BACKGROUND: In recent years, new radiographic diagnostics have increased our knowledge about dissection of the carotid and vertebral arteries as a cause of stroke, probably an underdiagnosed condition. Carotid dissection is now considered one of the most frequent aetiologies of ischaemic stroke in patients less than 50 years of age and it accounts for 20% of all cases under the age of 30. MATERIAL AND METHODS: In this paper we describe clinical course and investigations in four patients who had dissection of the precerebral arteries. RESULTS: Three patients had carotid artery dissection, one vertebral artery dissection. Three patients had ischaemic symptoms. One patient had symptoms following physiotherapy to the neck. INTERPRETATION: Patients with craniocervical arterial dissection should be investigated with ultrasound techniques and MRI or CT; antiplatelet agents or anticoagulation therapy should be considered.