Diagnosis and Treatment of Cervical Artery Dissection

被引:52
|
作者
Engelter, Stefan T. [1 ,2 ,3 ]
Traenka, Christopher [1 ,2 ]
Von Hessling, Alexander [4 ]
Lyrer, Philippe A. [1 ,2 ]
机构
[1] Univ Basel Hosp, Dept Neurol, CH-4031 Basel, Switzerland
[2] Univ Basel Hosp, Stroke Ctr, CH-4031 Basel, Switzerland
[3] Univ Ctr Med Aging & Rehabil, Felix Platter Hosp, Neurorehabil Unit, CH-4012 Basel, Switzerland
[4] Univ Basel Hosp, Dept Radiol, Neuroradiol & Stroke Ctr, CH-4031 Basel, Switzerland
基金
瑞士国家科学基金会;
关键词
Cervical artery dissection; Stroke; IV thrombolysis; Antipatelets; Anticoagulants; Endovascular treatment; Surgery; INTERNAL CAROTID-ARTERY; ASSISTED ENDOVASCULAR THROMBOLYSIS; ACUTE ISCHEMIC-STROKE; TERM FOLLOW-UP; INTRAVENOUS THROMBOLYSIS; TRANSCRANIAL DOPPLER; DELAYED OCCLUSION; YOUNG-ADULTS; ANTICOAGULATION; MANAGEMENT;
D O I
10.1016/j.ncl.2014.12.002
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Cervical artery dissection (CAD) is a major cause of stroke in the young. A mural hematoma is detected in most CAD patients. The intramural blood accumulation should not be considered a reason to withhold intravenous thrombolysis in patients with CAD-related stroke. Because intravenous-thrombolyzed CAD patients might not recover as well as other stroke patients, acute endovascular treatment is an alternative. Regarding the choice of antithrombotic agents, this article discusses the findings of 4 meta-analyses across observational data, the current status of 3 randomized controlled trials, and arguments and counterarguments favoring anticoagulants over antiplatelets. Furthermore, the role of stenting and surgery is addressed.
引用
收藏
页码:421 / +
页数:23
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