User:Mr. Ibrahem/Vertebral artery dissection

Vertebral artery dissection (VAD) is a flap-like tear of the inner lining of the vertebral artery, which is located in the neck and supplies blood to the brain. Initial symptoms are generally a sudden onset of headache and one sided neck pain. This may be accompanied stroke symptoms such as difficulty speaking, impaired coordination, or double vision. Complications may include subarachnoid bleeding.

They may occur after a physical injury to the neck, such as coughing, traffic collision, strangulation, or chiropractic manipulation, but may also happen spontaneously. People with connective tissue disorder, such as Ehlers-Danlos syndrome, are at increased risk. After the tear, blood enters the arterial wall and forms a blood clot, thickening the artery wall and often impeding blood flow. Diagnosis is usually by contrast-enhanced CT or MRI scan.

Treatment is usually with either antiplatelet drugs such as aspirin or with anticoagulants such as heparin or warfarin. About 10% of people die at the onset. Of those who survive this initial period, about 75% recover completely or with minimal impact on functioning, with the remainder having more severe disability, and about 2% dying from complications.

Vertebral artery dissection occurs in about 1 per 100,000 people per year. It is less common than carotid artery dissection (dissection of the large arteries in the front of the neck). The two conditions together account for 10–25% of non-bleeding strokes in young and middle-aged people. The condition was first fully described in the 1970s by the Canadian neurologist C. Miller Fisher.