Cervico-cerebral artery dissection

Eight patients, 3 males and 5 females, with cervico-cerebral artery dissection were studied. Their ages ranged from 26 to 51 years, with a mean of 41 years. Dissection occurred in the cervical carotid artery in 7 patients and in the vertebral artery in 1. All the patients had symptoms suggestive of ischemic stroke. Among them, 7 had headaches (most were ipsilateral to the lesion), 3 had oculosympathetic palsy, 2 had transient ischemic attacks, and 2 had a history of recent head trauma. The angiograms showed characteristic, long, segmental narrowing of the artery in 4 patients (with an extraluminal outpouch in 1) and post-sinus tapering occlusion of the cervical internal carotid artery in 4 patients. One of the patients received an extracranial-to-intracranial bypass operation, the others were treated with anticoagulants or antiplatelets. Significant resolution of the previous lesions was found in 3 cases. The clinical course was largely one of stability or improvement.