High Cervical Carotid Artery Dissection: Spontaneous Resolution

Abstract

The radiologic hallmark of intramural dissection of the high cervical internal carotid artery is asymmetric stenosis of the vessel lumen, The region of stenosis is generally centered at the C1-C2 level of the cervical spine, although the length of involvement may be considerably longer. Spontaneous dissection occurs unilaterally and is usually unrelated to atherosclerotic changes in the involved vessel. When the patient survives the initial event and its accompanying neurologic deficit, this diagnosis can be determined angiographically. This form of carotid artery dissection, occurring without pseudoaneurysm formation, generally resolves with conservation management.