What is the mechanism of injury for a vertebral artery dissection?
Traumatic vertebral artery dissection may be caused by major penetrating or blunt neck trauma. The incidence of vertebral artery injury among patients with blunt neck trauma is estimated at 0.20%–0.77%. Major mechanisms of injury are distraction/extension, distraction/flexion, and lateral flexion.
What type of injury is more likely related to vertebral artery dissection?
Traumatic injuries are most frequently due to blunt injury to the head and neck but may be due to penetrating trauma. Spontaneous injuries are caused by intrinsic weakness of the vessel wall, often due to underlying vascular or connective tissue disorder, leading to a dissection of the vessel.
What are the side effects of vertebral artery dissection?
Signs and symptoms
- Ipsilateral facial dysesthesia (pain and numbness) – Most common symptom.
- Dysarthria or hoarseness (cranial nerves [CN] IX and X)
- Contralateral loss of pain and temperature sensation in the trunk and limbs.
- Ipsilateral loss of taste (nucleus and tractus solitarius)
- Nausea and vomiting.
What is the most common cause of vertebral artery dissection?
Blunt trauma to the neck is the most common reported precipitating event. Patients with connective tissue disorders are also at increased risk. Ehlers-Danlos syndrome is the most common connective tissue disorder that can cause vertebral artery dissection.
How do you fix a vertebral artery dissection?
The two main treatments involve medication: anticoagulation (using heparin and warfarin) and antiplatelet drugs (usually aspirin). More rarely, thrombolysis (medication that dissolves blood clots) may be administered, and occasionally obstruction may be treated with angioplasty and stenting.
How do I know if I have vertebral artery dissection?
In the case of vertebral artery disease, symptoms may be minimal or severe. Symptoms run the gamut from vertigo, nausea and vomiting, changes in level of consciousness, headache, and speech disturbance as well as obvious severe neurologic deficits.
How is vertebral artery dissection classified as traumatic?
Vertebral artery dissection is further classified as being either traumatic (caused by mechanical trauma to the neck) or spontaneous, and it may also be classified by the part of the artery involved: extracranial (the part outside the skull) and intracranial (the part inside the skull).
Can a vertebral artery dissection be a lethal condition?
Vertebral artery dissection, like arterial dissection elsewhere, is a result of blood entering the media through a tear in the intima. It is potentially lethal and can be difficult to diagnose clinically and radiologically.
What causes dissection of the extracranial Vas?
VA dissection can occur as a result of different trauma types that cause excessive cervical rotation, distraction, or flexion-extension injuries. Extracranial components of the VAs have a higher likelihood of dissecting; however, up to 10% of extracranial VA dissections extend intracranially.
Is there risk of subarachnoid hemorrhage in vertebral artery dissection?
In intracranial dissection, there is a high risk of subarachnoid hemorrhage (up to 50% for vertebrobasilar dissections 3) on account of the anatomy of intracranial arteries. The vertebral arteries, like the ICA, have a differing distribution of elastic fibers compared to similar-sized vessels elsewhere (this has been disputed by FT Merei 14 ).