Carotid artery dissection refers to an intimal tear and eventually hematoma of the carotid artery wall. Although medical therapy is the mainstay of treatment, surgical or endovascular procedures may be indicated to address fluctuating neurologic deficit or expanding pseudoaneurysm. This review surveys the pathophysiology and natural history of carotid dissection and summarizes the results of recent trials and evolving therapeutic options. A table highlights factors predisposing to or potentially associated with carotid dissection. Figures include an illustration of the pathophysiology of internal carotid artery dissection (ICAD); angiograms revealing right internal carotid artery tapering stenosis to occlusion, right internal carotid artery carotid dissection, and distal left ICAD; ultrasound findings of ICAD; and an algorithm for the diagnosis and management of carotid dissection.
This review contains 6 figures, 1 table, and 83 references.
