Sign Up for a Free Account
  • Updated 06.26.2022
  • Released 04.10.1995
  • Expires For CME 06.26.2025

Spontaneous carotid and vertebral artery dissection



Cerebral artery dissection is the most common cause of stroke in young adults. Recent studies provide insights into the pathophysiology, risk factors, management, and outcome of this condition. In this article, the authors provide a comprehensive review of spontaneous (nontraumatic) carotid and vertebral artery dissections.

Historical note and terminology

The first description of spontaneous dissection of the cervical arteries dates back to 1915 (143). In 1959, Anderson and Schechter were the first to clearly document a case of spontaneous dissecting aneurysm of the internal carotid artery (02; 32). The term "dissection," from the Latin verb disseco, implied the separation of anatomic structures along the natural lines by tearing of the connective tissue framework. As it is applied to vascular pathology, it relates to the separation of the different layers that constitute the arterial wall. This process can occur either spontaneously or following blunt trauma to the vessel. Sub-intimal dissections can cause lumen stenosis, and sub-adventitial dissections can cause aneurysmal dilatation. Strictly speaking, the lesion of dissection is a “dissecting aneurysm” and includes layers of the normal vessel wall (61). The term “pseudoaneurysm” is often used incorrectly for this same purpose, but this term refers to lesions that do not include components of the normal vessel wall. An example of pseudoaneurysm is a posttraumatic event where the vessel wall is severed and adjacent connective tissue maintains a lumen.

This is an article preview.
Start a Free Account
to access the full version.

  • Nearly 3,000 illustrations, including video clips of neurologic disorders.

  • Every article is reviewed by our esteemed Editorial Board for accuracy and currency.

  • Full spectrum of neurology in 1,200 comprehensive articles.

  • Listen to MedLink on the go with Audio versions of each article.

Questions or Comment?

MedLink®, LLC

3525 Del Mar Heights Rd, Ste 304
San Diego, CA 92130-2122

Toll Free (U.S. + Canada): 800-452-2400

US Number: +1-619-640-4660



ISSN: 2831-9125