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emDOCs.net Emergency Medicine (EM) Podcast

Episode 97: Spontaneous Cervical Artery Dissection

Mar 19, 2024
Explore the challenging diagnosis of spontaneous cervical artery dissection, its symptoms, and risk factors. Learn how to distinguish cervical artery dissection from stroke and discover management strategies including imaging techniques, anti-thrombotic therapy, and emergency department management.
11:20

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Quick takeaways

  • Spontaneous cervical artery dissection can lead to various complications like stenosis, thromboembolism, aneurysm formation, or nerve compression.
  • Patients with SCAD may present with symptoms such as neck pain, headache, Horner syndrome, or pulsatile tinnitus, necessitating CTA for diagnosis and stroke prevention.

Deep dives

Overview of SCAD Pathology

Spontaneous cervical artery dissection (SCAD) involves a tear in the arterial wall layers of the carotid or vertebral arteries, leading to intramural hematoma, stenosis, occlusion, thromboembolism, aneurysm formation, or compression of surrounding nerves and vasculature. It is a common cause of strokes in young individuals, accounting for 15 to 24 percent of strokes in patients less than 45, with risk factors including connective tissue disorders and vascular disease.

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