Once cervical artery dissection has been confirmed the mainstay of treatment is antithrombotic therapy. The options include antiplatelet therapy vs anticoagulation, the latter being the historic preference.

There have been recent studies including meta-analyses comparing anticoagulation to anti platelet therapy in preventing stroke following carotid and vertebral artery dissection. The current evidence does not suggest superiority of anticoagulation or anti platelet therapy. [4,5]

Local practice may therefore vary and so consultation with specialist in patient teams is recommended prior to commencing treatment.


In patients with head trauma, it is important to exclude haemorrhage with a CT brain scan prior to instituting anticoagulation.

As there are inherent risks associated with anticoagulation, in some patients, it may be decided that treatment with aspirin alone is the best approach, particularly those without neurological signs.

Endovascular stenting is a further option, particularly for patients with a contraindication to anticoagulation.

Mortality is around 5-10%, but of those surviving 75-80% will make a complete recovery. [6]

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valuable point

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