Dissections of cerebral arteries are most often treated in a conservative manner with the use of antithrombotic drugs. This is justified by the relatively benign cause of the disease after the initial event. However, there are some exceptions from this rule: Stent treatment of stenotic dissections should be considered in patients who are hemodynamically compromised or recurrently symptomatic. Dissecting pseudoaneurysms must be treated after subarachnoid hemorrhage or in traumatic cases. Parent vessel occlusion is still the best option in this condition. Coiling with soft coils or stenting + coiling may be an alternative in cases without sufficient collaterals or in unruptured dissecting aneurysms.
LisovoskiFRousseauxP: Cerebral infarction in young people. A study of 148 patients with early cerebral angiography. J Neurol Neurosurg Psychiatry54: 576–9, 1991.
2.
BogousslavskyJPierreP: Ischemic stroke in patients under age 45. Neurol Clin10: 113–24, 1992.
3.
SaverJLEastonJDHartGH: Dissections and trauma of cervicocerebral arteries. In: BarnettHJMohrJPSteinBMYatsuFM, eds. Stroke: Pathophysiology, Diagnosis and Managment. 2nd ed.New York: Churchill Livingstone: 671–688, 1992.
4.
SchievinkWI: Spontaneous dissection of the carotid and vertebral arteries. N Engl J Med.344: 898–906, 2001.
5.
AlimiYDi MauroPTomachotL: Bilateral dissection of the internal carotid artery at the base of the skull due to blunt trauma: Incidence and severity. Ann Vasc Surg12: 557–65, 1998.
6.
SchievinkWIMokriBPiepgrasDG: Spontaneous dissections of cervicocephalic arteries in childhood and adolescence. Neurology44: 1607–12, 1994.
7.
BenningerDHGeorgiadisDKremerC: Mechanism of ischemic infarct in spontaneous carotid dissection. Stroke35: 482–5, 2004.
BejjaniGKMonseinLHLairdJR: Treatment of symptomatic cervical carotid dissections with endovascular stents. Neurosurgery44: 755–60; discussion 760–1, 1999.
12.
MalekAMHigashidaRTPhatourosCC: Endovascular management of extracranial carotid artery dissection achieved using stent angioplasty. AJNR Am J Neuroradiol21: 1280–92, 2000.
13.
ScaveeVDe WispelaereJFMormontE: Pseudoaneurysm of the internal carotid artery: Treatment with a covered stent. Cardiovasc Intervent Radiol24: 283–5, 2001.
14.
du MesnilRBerkefeldJBeckJ: Transmural dissection of the intradural vertebral artery as cause of subarachnoid hemorrhage: Endovascular treatment. Article in German. Klinische Neuroradiologie13: 66–70, 2003.
15.
LylykPCohenJECerattoR: Combined endovascular treatment of dissecting vertebral artery aneurysms by using stents and coils. J Neurosurg.94: 427–32, 2001.
