Is Digital Subtraction Angiography Still the Method of Choice for Diagnosis and Follow-up of Cervical Artery Dissection?

Cervical Artery Dissection (CAD) accounts for up to one fifth of ischaemic strokes occurring before 45 years. The internal carotid artery is the most commonly affected vessel. Cerebral ischemia is the most serious consequence of carotid artery dissection. The enlargement of the artery may lead to laterocervical pain and direct compression of the lower cranial nerves and/or sympathetic peri-carotid plexus. A spontaneous dissection is assumed when no or only minor trauma preceded the onset. The pathogenesis of dissections remains unknown in most cases, but traumas and primary diseases of the arterial wall are the main predisposing factors.We monitored six patients with CAD (four males, two females; 32–67 years old). All patients underwent US and CT-CTA examinations; five patients had DSA; four patients underwent MRI-MRA within the first two weeks after clinical onset. Four patients have received intravenous heparin treatment followed by oral anticoagulant therapy. Patients were then followed up with US alon...