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Purpose of Review <p>Cervical artery dissection (CeAD) is a rare yet significant cause of ischemic stroke, particularly among individuals under 50&#xa0;years of age, in whom it accounts for up to 25% of strokes. This review provides an overview of current trends in hyperacute and acute treatment strategies and discusses long-term management approaches. We examine the literature on short-term and long-term secondary prevention strategies and the role of acute interventions such as intravenous thrombolysis and mechanical thrombectomy.</p> Recent Findings <p>The therapeutic management of CeAD is broadly categorized into three key phases: the hyperacute period, focusing on the emergent treatment of acute ischemic stroke; primary and secondary stroke prevention strategies; and the management of associated symptoms and sequelae. Recent findings on the hyperacute management of CeAD highlight the feasibility and safety of intravenous thrombolysis and mechanical thrombectomy in the treatment of acute ischemic stroke. Antithrombotic therapy is crucial for both primary and secondary stroke prevention, involving the use of anticoagulation or antiplatelet regimens. However, treatment decisions should be individualized to balance the prevention of ischemic stroke with hemorrhagic risk. Emerging evidence suggests that a short, intensive course of antithrombotic therapy followed by de-escalation may effectively reduce the risk of ischemic stroke while minimizing hemorrhagic risk.</p> Summary <p>CeAD can be associated with a broad spectrum of symptoms ranging from mild to severe neurological deficits. Acute management, including thrombolysis and mechanical thrombectomy, is essential for treating ischemic stroke, while long-term antithrombotic therapy aims to prevent recurrence and support vessel healing. The choice of anticoagulation or antiplatelet therapy remains a subject of ongoing debate. While many patients experience spontaneous recovery, some continue to face long-term challenges, such as recurrent strokes and chronic pain. These sequelae underscore the need for further research to refine treatment approaches and improve patient outcomes.</p>

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Updates in the Management of Cervical Artery Dissections

  • 期刊论文

  • 发表日期：

    2025年2月13日

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  • Emin Cagil,
  • Helena Xeros,
  • Zafer Keser

摘要

Purpose of Review

Cervical artery dissection (CeAD) is a rare yet significant cause of ischemic stroke, particularly among individuals under 50 years of age, in whom it accounts for up to 25% of strokes. This review provides an overview of current trends in hyperacute and acute treatment strategies and discusses long-term management approaches. We examine the literature on short-term and long-term secondary prevention strategies and the role of acute interventions such as intravenous thrombolysis and mechanical thrombectomy.

Recent Findings

The therapeutic management of CeAD is broadly categorized into three key phases: the hyperacute period, focusing on the emergent treatment of acute ischemic stroke; primary and secondary stroke prevention strategies; and the management of associated symptoms and sequelae. Recent findings on the hyperacute management of CeAD highlight the feasibility and safety of intravenous thrombolysis and mechanical thrombectomy in the treatment of acute ischemic stroke. Antithrombotic therapy is crucial for both primary and secondary stroke prevention, involving the use of anticoagulation or antiplatelet regimens. However, treatment decisions should be individualized to balance the prevention of ischemic stroke with hemorrhagic risk. Emerging evidence suggests that a short, intensive course of antithrombotic therapy followed by de-escalation may effectively reduce the risk of ischemic stroke while minimizing hemorrhagic risk.

Summary

CeAD can be associated with a broad spectrum of symptoms ranging from mild to severe neurological deficits. Acute management, including thrombolysis and mechanical thrombectomy, is essential for treating ischemic stroke, while long-term antithrombotic therapy aims to prevent recurrence and support vessel healing. The choice of anticoagulation or antiplatelet therapy remains a subject of ongoing debate. While many patients experience spontaneous recovery, some continue to face long-term challenges, such as recurrent strokes and chronic pain. These sequelae underscore the need for further research to refine treatment approaches and improve patient outcomes.