r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2022-27-4-86-96r-n-j-341Research ArticleЛЕКЦИЯLECTUREЦервикальная диссекция в экстренной неврологии: алгоритмы диагностики и леченияCervical dissection in emergency neurology: diagnostic and treatment algorithmsКулешА. А.KuleshA. A.

Пермь

Perm

aleksey.kulesh@gmail.comДеминД. А.DeminD. A.

Астрахань

Astrakhan

ВиноградовО. И.VinogradovO. I.

Москва

Moscow

olvinog@mail.ru«Пермский государственный медицинский университет имени академика Е.А. Вагнера» Минздрава РоссииРоссияWagner Perm State Medical UniversityRussian Federation«Федеральный центр сердечно-сосудистой хирургии» Минздрава РоссииРоссияFederal Central of Vascular SurgeryRussian Federation«Национальный медико-хирургический центр им. Н.И. Пирогова» Минздрава РоссииРоссияPirogov National Medical and Surgical CenterRussian Federation2022031020222748696Copyright © Кулеш А.А., Демин Д.А., Виноградов О.И., 20222022Кулеш А.А., Демин Д.А., Виноградов О.И.Kulesh A.A., Demin D.A., Vinogradov O.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/341

Обсуждается эпидемиология цервикальной диссекции (ЦД), которая часто не устанавливается как причина ишемического инсульта и транзиторной ишемической атаки (ТИА). Рассмотрены патоморфология и патогенез ЦД, ключевой особенностью которых является развитие интрамуральной гематомы, а также предрасполагающие состояния, триггеры и ассоциированные клинические состояния, в частности мигрень. Представлена клиническая картина заболевания в виде локальных симптомов (головная и/или шейная боль, синдром Горнера, поражение каудальной группы черепных нервов, шейный корешковый синдром, пульсирующий тиннитус) и острых ишемических событий (ишемический инсульт или ТИА). Отражены современные подходы к экстренной нейро- и ангиовизуализации при ЦД, включая возможности КТ-ангиографии (прямые и косвенные признаки) и МРТ fat sat (симптом «полумесяца»). Представлены диагностические критерии. Обсуждены вопросы реперфузионной терапии при ЦД — внутривенного тромболизиса, тромбэктомии и стентирования. Анализируются течение заболевания и современные возможности вторичной антитромботической профилактики, включая эффективность и безопасность антитромбоцитарных препаратов и антикоагулянтов.

The epidemiology of cervical artery dissection (CAD), which is often not thought to be the cause of ischemic stroke and transient ischemic attack (TIA), is discussed. The pathomorphology and pathogenesis of CAD, the key feature of which is the development of intramural hematoma, as well as predisposing conditions, triggers and associated conditions, in particular migraine, are reviewed. The clinical picture of diseases — local symptoms (headache and/ or neck pain, Horner’s syndrome, caudal cranial nerve involvement, cervical radicular syndrome, pulsatile tinnitus) and ischemic events (ischemic stroke or TIA) is presented. Modern approaches to urgent neuro- and angioimaging in CAD are reflected, including the possibilities of CT angiography (direct and indirect signs) and fat sat MRI (crescent symptom). Issues of reperfusion therapy (intravenous thrombolysis, thrombectomy and stenting) are discussed. The course of disease and secondary antithrombotic prophylaxis are analyzed.

цервикальная диссекцияинсульттранзиторная ишемическая атакаcervical artery dissectionstroketransient ischemic attackReferencesDebette S., Leys D. Cervical-artery dissections: predisposing factors, diagnosis, and outcome. Lancet Neurol. 2009;8(7):668–78. https://doi.org/10.1016/S1474-4422(09)70084-5Debette S., Leys D. Cervical-artery dissections: predisposing factors, diagnosis, and outcome. Lancet Neurol. 2009;8(7):668–78. https://doi.org/10.1016/S1474-4422(09)70084-5Debette S. Pathophysiology and risk factors of cervical artery dissection: what have we learnt from large hospital-based cohorts? Curr Opin Neurol. 2014;27(1):20–8. https://doi.org/10.1097/WCO.0000000000000056Debette S. Pathophysiology and risk factors of cervical artery dissection: what have we learnt from large hospital-based cohorts? Curr Opin Neurol. 2014;27(1):20–8. https://doi.org/10.1097/WCO.0000000000000056Engelter S.T., Traenka C., Lyrer P. Dissection of Cervical and Cerebral Arteries. Curr Neurol Neurosci Rep. 2017;17(8):59. https://doi.org/10.1007/s11910-017-0769-3Engelter S.T., Traenka C., Lyrer P. Dissection of Cervical and Cerebral Arteries. Curr Neurol Neurosci Rep. 2017;17(8):59. https://doi.org/10.1007/s11910-017-0769-3Traenka C., Dougoud D., Simonetti B.G., Metso T.M., Debette S., Pezzini A. et al. CADISP-Plus Study Group. Cervical artery dissection in patients ≥ 60 years: Often painless, few mechanical triggers. Neurology. 2017;88(14):1313–1320. https://doi.org/10.1212/WNL.0000000000003788Traenka C., Dougoud D., Simonetti B.G., Metso T.M., Debette S., Pezzini A. et al. CADISP-Plus Study Group. Cervical artery dissection in patients ≥ 60 years: Often painless, few mechanical triggers. Neurology. 2017;88(14):1313–1320. https://doi.org/10.1212/WNL.0000000000003788Atalay Y.B., Piran P., Chatterjee A., Murthy S., Navi B.B., Liberman A.L. et al. Prevalence of Cervical Artery Dissection Among Hospitalized Patients With Stroke by Age in a Nationally Representative Sample From the United States. Neurology. 2021;96(7):e1005–e1011. https://doi.org/10.1212/WNL.0000000000011420Atalay Y.B., Piran P., Chatterjee A., Murthy S., Navi B.B., Liberman A.L. et al. Prevalence of Cervical Artery Dissection Among Hospitalized Patients With Stroke by Age in a Nationally Representative Sample From the United States. Neurology. 2021;96(7):e1005–e1011. https://doi.org/10.1212/WNL.0000000000011420Metso A.J., Metso T.M., Debette S., Dallongeville J., Lyrer P.A., Pezzini A. et al. CADISP Group. Gender and cervical artery dissection. Eur J Neurol. 2012;19(4):594–602. https://doi.org/10.1111/j.1468-1331.2011.03586.xMetso A.J., Metso T.M., Debette S., Dallongeville J., Lyrer P.A., Pezzini A. et al. CADISP Group. Gender and cervical artery dissection. Eur J Neurol. 2012;19(4):594–602. https://doi.org/10.1111/j.1468-1331.2011.03586.xRiou-Comte N., Mione G., Humbertjean L., Ottenin M.A., Lacour J.C., Richard S. Spontaneous cervical artery dissection in patients aged over 70 years: two cases and systematic literature review. Clin Interv Aging. 2017;12:1355–1362. Published 2017 Aug 26. https://doi.org/10.2147/CIA.S138980Riou-Comte N., Mione G., Humbertjean L., Ottenin M.A., Lacour J.C., Richard S. Spontaneous cervical artery dissection in patients aged over 70 years: two cases and systematic literature review. Clin Interv Aging. 2017;12:1355–1362. Published 2017 Aug 26. https://doi.org/10.2147/CIA.S138980Lee V.H., Brown R.D. Jr., Mandrekar J.N., Mokri B. Incidence and outcome of cervical artery dissection: a populationbased study. Neurology. 2006;67(10):1809–12. https://doi.org/10.1212/01.wnl.0000244486.30455.71Lee V.H., Brown R.D. Jr., Mandrekar J.N., Mokri B. Incidence and outcome of cervical artery dissection: a populationbased study. Neurology. 2006;67(10):1809–12. https://doi.org/10.1212/01.wnl.0000244486.30455.71Калашникова Л.А., Гулевская Т.С., Ануфриев П.Л., Коновалов Р.Н., Щипакин А.О., Авдюнина И.А., и др. Поражение каудальной группы черепных нервов при диссекции (расслоении) внутренней сонной артерии. Анналы клинической и экспериментальной неврологии. 2008;2(1):22–27.Kalashnikova L.A., Gulevskaja T.S., Anufriev P.L., Konovalov R.N., Shhipakin A.O., Avdjunina I.A. et al. Lоwer cranial nerve palsiаs in the internаl carotid artery dissection. Annaly klinicheskoj i jeksperimental’noj nevrologii. 2008;2(1):22–27. (In Russ.).Калашникова Л.А. Диссекция внутренних сонных и позвоночных артерий: клиника, диагностика лечение. Неврология, нейропсихиатрия, психосоматика. 2013;(спецвып.2):40–45. https://doi.org/10.14412/2074-2711-2013-2357Kalashnikova L.A. Dissection of internal carotid and vertebral arteries: clinical presentation, diagnosis, and treatment. Neurology, neuropsychiatry, psychosomatics. 2013;(S2):40–45. (In Russ.). https://doi.org/10.14412/2074-2711-2013-2357Калашникова Л.А., Добрынина Л А., Древаль М.В., Доронина Е.В., Назарова М.А. Шейная и головная боль как единственное проявление диссекции внутренней сонной и позвоночной артерий. Журнал неврологии и психиатрии им. С.С. Корсакова. 2015;115(3):9–16. https://doi.org/10.17116/jnevro2015115319-16Kalashnikova L.A., Dobrynina L.A., Dreval’ M.V., Doronina E.V., Nazarova M.A. Neck pain and headache as the only manifestation of cervical artery dissection. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2015;115(3):9–16. (In Russ.). https://doi.org/10.17116/jnevro2015115319-16Калашникова Л.А., Добрынина Л.А., Чечеткин А.О., Древаль М.В., Кротенкова М.В., Захаркина М.В. Нарушения мозгового кровообращения при диссекции внутренней сонной и позвоночной артерий. Алгоритм диагностики. Нервные болезни. 2016;2:10–15.Kalashnikova L.A., Dobrynina L.A., Chechetkin A.O., Dreval’ M.V., Krotenkova M.V., Zaharkina M.V. Cerebral circulation disorders during dissection of the internal carotid and vertebral arteries. Diagnostic algorithm. Nervnye bolezni. 2016;2:10–15. (In Russ.).Калашникова Л.А., Добрынина Л.А., Максимова М.Ю., Танашян М.М., Данилова М.С., Древаль М.В. Диссекция внутренней сонной и позвоночной артерий: тактика ведения пациентов. Анналы клинической и экспериментальной неврологии. 2021;15(1):5–12. https://doi.org/10.25692/ACEN.2021.1.1Kalashnikova L.A., Dobrynina L.A., Maksimova M.Ju., Tanashjan M.M., Danilova M.S., Dreval’ M.V. Internal carotid and vertebral artery dissection: an approach to patient management. Annaly klinicheskoj i jeksperimental’noj nevrologii. 2021;15(1):5–12. (In Russ.). https://doi.org/10.25692/ACEN.2021.1.1Кулеш А.А., Нуриева Ю.А., Сыромятникова Л.И. Причины ишемического инсульта у пациентов моложе 45 лет: анализ данных регионального сосудистого центра. Неврология, нейропсихиатрия, психосоматика. 2021;13(1):24–30. https://doi.org/10.14412/2074-2711-2021-1-24-30Kulesh A.A., Nurieva Yu.A., Syromyatnikova L.I. Causes of ischemic stroke in patients younger than 45 years: analysis of data from the regional vascular center. Neurology, Neuropsychiatry, Psychosomatics. 2021;13(1):24–30. (In Russ.). https://doi.org/10.14412/2074-2711-2021-1-24-30Debette S., Mazighi M., Bijlenga P., Pezzini A., Koga M., Bersano A. et al. ESO guideline for the management of extracranial and intracranial artery dissection. European Stroke Journal. 2021;6(3):XXXIX–LXXXVIII. https://doi.org/10.1177/23969873211046475Debette S., Mazighi M., Bijlenga P., Pezzini A., Koga M., Bersano A. et al. ESO guideline for the management of extracranial and intracranial artery dissection. European Stroke Journal. 2021;6(3):XXXIX–LXXXVIII. https://doi.org/10.1177/23969873211046475Engelter S.T., Lyrer P.,Traenka C. Cervical and intracranial artery dissections. Ther Adv Neurol Disord. 2021;14:17562864211037238. https://doi.org/10.1177/17562864211037238Engelter S.T., Lyrer P.,Traenka C. Cervical and intracranial artery dissections. Ther Adv Neurol Disord. 2021;14:17562864211037238. https://doi.org/10.1177/17562864211037238Mehdi E., Aralasmak A., Toprak H., Yıldız S., Kurtcan S., Kolukisa M. et al. Craniocervical Dissections: Radiologic Findings, Pitfalls, Mimicking Diseases: A Pictorial Review. Curr Med Imaging Rev. 2018;14(2):207–222. https://doi.org/10.2174/1573405613666170403102235Mehdi E., Aralasmak A., Toprak H., Yıldız S., Kurtcan S., Kolukisa M. et al. Craniocervical Dissections: Radiologic Findings, Pitfalls, Mimicking Diseases: A Pictorial Review. Curr Med Imaging Rev. 2018;14(2):207–222. https://doi.org/10.2174/1573405613666170403102235Béjot Y., Aboa-Eboulé C., Debette S., Pezzini A., Tatlisumak T., Engelter S. et al. CADISP Group. Characteristics and outcomes of patients with multiple cervical artery dissection. Stroke. 2014;45(1):37–41. https://doi.org/10.1161/STROKEAHA.113.001654Béjot Y., Aboa-Eboulé C., Debette S., Pezzini A., Tatlisumak T., Engelter S. et al. CADISP Group. Characteristics and outcomes of patients with multiple cervical artery dissection. Stroke. 2014;45(1):37–41. https://doi.org/10.1161/STROKEAHA.113.001654Guglielmi V., Visser J., Arnold M., Sarikaya H., van den Berg R., Nederkoorn P.J. et al. Triple and quadruple cervical artery dissections: a systematic review of individual patient data. J Neurol. 2019;266(6):1383–1388. https://doi.org/10.1007/s00415-019-09269-1Guglielmi V., Visser J., Arnold M., Sarikaya H., van den Berg R., Nederkoorn P.J. et al. Triple and quadruple cervical artery dissections: a systematic review of individual patient data. J Neurol. 2019;266(6):1383–1388. https://doi.org/10.1007/s00415-019-09269-1Brandt T., Orberk E., Weber R., Werner I., Busse O., Müller B.T. et al. Pathogenesis of cervical artery dissections: association with connective tissue abnormalities. Neurology. 2001;57(1):24–30. https://doi.org/10.1212/wnl.57.1.24Brandt T., Orberk E., Weber R., Werner I., Busse O., Müller B.T. et al. Pathogenesis of cervical artery dissections: association with connective tissue abnormalities. Neurology. 2001;57(1):24–30. https://doi.org/10.1212/wnl.57.1.24Engelter S.T., Grond-Ginsbach C., Metso T.M., Metso A.J., Kloss M., Debette S. et al. Cervical Artery Dissection and Ischemic Stroke Patients Study Group. Cervical artery dissection: trauma and other potential mechanical trigger events. Neurology. 2013;80(21):1950–7. https://doi.org/10.1212/WNL.0b013e318293e2ebEngelter S.T., Grond-Ginsbach C., Metso T.M., Metso A.J., Kloss M., Debette S. et al. Cervical Artery Dissection and Ischemic Stroke Patients Study Group. Cervical artery dissection: trauma and other potential mechanical trigger events. Neurology. 2013;80(21):1950–7. https://doi.org/10.1212/WNL.0b013e318293e2ebEngelter S.T., Traenka C., Grond-Ginsbach C., Brandt T., Hakimi M., Worrall B.B. et al. Cervical Artery Dissection and Sports. Front Neurol. 2021;12:663830. https://doi.org/10.3389/fneur.2021.663830Engelter S.T., Traenka C., Grond-Ginsbach C., Brandt T., Hakimi M., Worrall B.B. et al. Cervical Artery Dissection and Sports. Front Neurol. 2021;12:663830. https://doi.org/10.3389/fneur.2021.663830Strambo D., Sirimarco G., Inácio N., Eskandari A., Michel P. Skiing Associated Stroke: Causes, Treatment, and Outcome. J Stroke Cerebrovasc Dis. 2019;28(2):288–294. https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.09.049Strambo D., Sirimarco G., Inácio N., Eskandari A., Michel P. Skiing Associated Stroke: Causes, Treatment, and Outcome. J Stroke Cerebrovasc Dis. 2019;28(2):288–294. https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.09.049Baldino G., Di Girolamo C., De Blasis G., Gori A. Eagle Syndrome and Internal Carotid Artery Dissection: Description of Five Cases Treated in Two Italian Institutions and Review of the Literature. Ann Vasc Surg. 2020;67:565.e17 — 565.e24. https://doi.org/10.1016/j.avsg.2020.02.033Baldino G., Di Girolamo C., De Blasis G., Gori A. Eagle Syndrome and Internal Carotid Artery Dissection: Description of Five Cases Treated in Two Italian Institutions and Review of the Literature. Ann Vasc Surg. 2020;67:565.e17 — 565.e24. https://doi.org/10.1016/j.avsg.2020.02.033Hunter M.D., Moon Y.P., Miller E.C., Kulick E.R., Boehme A.K., Elkind M.S. Influenza-Like Illness is Associated with Increased Short-Term Risk of Cervical Artery Dissection. J Stroke Cerebrovasc Dis. 2021;30(2):105490. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105490Hunter M.D., Moon Y.P., Miller E.C., Kulick E.R., Boehme A.K., Elkind M.S. Influenza-Like Illness is Associated with Increased Short-Term Risk of Cervical Artery Dissection. J Stroke Cerebrovasc Dis. 2021;30(2):105490. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105490Metso T.M., Tatlisumak T., Debette S., Dallongeville J., Engelter S.T., Lyrer P.A. et al. CADISP group. Migraine in cervical artery dissection and ischemic stroke patients. Neurology. 2012;78(16):1221–8. https://doi.org/10.1212/WNL.0b013e318251595fMetso T.M., Tatlisumak T., Debette S., Dallongeville J., Engelter S.T., Lyrer P.A. et al. CADISP group. Migraine in cervical artery dissection and ischemic stroke patients. Neurology. 2012;78(16):1221–8. https://doi.org/10.1212/WNL.0b013e318251595fDe Giuli V., Grassi M., Lodigiani C., Patella R., Zedde M., Gandolfo C. et al. Italian Project on Stroke in Young Adults Investigators. Association Between Migraine and Cervical Artery Dissection: The Italian Project on Stroke in Young Adults. JAMA Neurol. 2017;74(5):512–518. https://doi.org/10.1001/jamaneurol.2016.5704De Giuli V., Grassi M., Lodigiani C., Patella R., Zedde M., Gandolfo C. et al. Italian Project on Stroke in Young Adults Investigators. Association Between Migraine and Cervical Artery Dissection: The Italian Project on Stroke in Young Adults. JAMA Neurol. 2017;74(5):512–518. https://doi.org/10.1001/jamaneurol.2016.5704West B.H., Noureddin N., Mamzhi Y., Low C.G., Coluzzi A.C., Shih E.J. et al. Frequency of Patent Foramen Ovale and Migraine in Patients With Cryptogenic Stroke. Stroke. 2018;49(5):1123–1128. https://doi.org/10.1161/STROKEAHA.117.020160West B.H., Noureddin N., Mamzhi Y., Low C.G., Coluzzi A.C., Shih E.J. et al. Frequency of Patent Foramen Ovale and Migraine in Patients With Cryptogenic Stroke. Stroke. 2018;49(5):1123–1128. https://doi.org/10.1161/STROKEAHA.117.020160De Giuli V., Graziano F., Zini A., Zedde M., Patella R., Lodigiani C. et al. Italian Project on Stroke in Young Adults (IPSYS) Investigators. Migraine improvement after spontaneous cervical artery dissection the Italian Project on Stroke in Young Adults (IPSYS). Neurol Sci. 2019;40(1):59–66. https://doi.org/10.1007/s10072-018-3578-9De Giuli V., Graziano F., Zini A., Zedde M., Patella R., Lodigiani C. et al. Italian Project on Stroke in Young Adults (IPSYS) Investigators. Migraine improvement after spontaneous cervical artery dissection the Italian Project on Stroke in Young Adults (IPSYS). Neurol Sci. 2019;40(1):59–66. https://doi.org/10.1007/s10072-018-3578-9Morelli N., Rota E., Michieletti E., Guidetti D. Spontaneous cervical artery dissection and prevalence of right-to-left shunt. Neurology and Neurobiology. 2018;1(1):2–3; https://doi.org/10.10xx/j.NNB.2018.10.001Morelli N., Rota E., Michieletti E., Guidetti D. Spontaneous cervical artery dissection and prevalence of right-to-left shunt. Neurology and Neurobiology. 2018;1(1):2–3; https://doi.org/10.10xx/j.NNB.2018.10.001Béjot Y., Aboa-Eboulé C., Debette S., Pezzini A., Tatlisumak T., Engelter S.et al. CADISP Group. Characteristics and outcomes of patients with multiple cervical artery dissection. Stroke. 2014;45(1):37–41. https://doi.org/10.1161/STROKEAHA.113.001654Béjot Y., Aboa-Eboulé C., Debette S., Pezzini A., Tatlisumak T., Engelter S.et al. CADISP Group. Characteristics and outcomes of patients with multiple cervical artery dissection. Stroke. 2014;45(1):37–41. https://doi.org/10.1161/STROKEAHA.113.001654von Sarnowski B., Schminke U., Grittner U., Fazekas F., Tanislav C., Kaps M. et al. Cervical artery dissection in young adults in the stroke in young Fabry patients (sifap1) study. Cerebrovasc Dis. 2015;39(2):110–21. https://doi.org/10.1159/000371338von Sarnowski B., Schminke U., Grittner U., Fazekas F., Tanislav C., Kaps M. et al. Cervical artery dissection in young adults in the stroke in young Fabry patients (sifap1) study. Cerebrovasc Dis. 2015;39(2):110–21. https://doi.org/10.1159/000371338Mawet J., Boukobza M., Franc J., Sarov M., Arnold M., Bousser M.G., Ducros A. Reversible cerebral vasoconstriction syndrome and cervical artery dissection in 20 patients. Neurology. 2013;81(9):821–4. https://doi.org/10.1212/WNL.0b013e3182a2cbe2Mawet J., Boukobza M., Franc J., Sarov M., Arnold M., Bousser M.G., Ducros A. Reversible cerebral vasoconstriction syndrome and cervical artery dissection in 20 patients. Neurology. 2013;81(9):821–4. https://doi.org/10.1212/WNL.0b013e3182a2cbe2Debette S., Grond-Ginsbach C., Bodenant M., Kloss M., Engelter S., Metso T. et al. Cervical Artery Dissection Ischemic Stroke Patients (CADISP) Group. Differential features of carotid and vertebral artery dissections: the CADISP study. Neurology. 2011;77(12):1174–81. https://doi.org/10.1212/WNL.0b013e31822f03fcDebette S., Grond-Ginsbach C., Bodenant M., Kloss M., Engelter S., Metso T. et al. Cervical Artery Dissection Ischemic Stroke Patients (CADISP) Group. Differential features of carotid and vertebral artery dissections: the CADISP study. Neurology. 2011;77(12):1174–81. https://doi.org/10.1212/WNL.0b013e31822f03fcVidale S. Headache in cervicocerebral artery dissection. Neurol Sci. 2020;41(Suppl.2):395–399. https://doi.org/10.1007/s10072-020-04651-8Vidale S. Headache in cervicocerebral artery dissection. Neurol Sci. 2020;41(Suppl.2):395–399. https://doi.org/10.1007/s10072-020-04651-8Wang Y., Cheng W., Lian Y., Zhang J., Zheng Y., Hu Y. et al. Characteristics and relative factors of headache caused by cervicocerebral artery dissection. J Neurol. 2019;266(2):298–305. https://doi.org/10.1007/s00415-018-9111-5Wang Y., Cheng W., Lian Y., Zhang J., Zheng Y., Hu Y. et al. Characteristics and relative factors of headache caused by cervicocerebral artery dissection. J Neurol. 2019;266(2):298–305. https://doi.org/10.1007/s00415-018-9111-5Lyrer P.A., Brandt T., Metso T.M., Metso A.J., Kloss M., Debette S. et al. Cervical Artery Dissection and Ischemic Stroke Patients (CADISP) Study Group. Clinical import of Horner syndrome in internal carotid and vertebral artery dissection. Neurology. 2014;82(18):1653–9. https://doi.org/10.1212/WNL.0000000000000381Lyrer P.A., Brandt T., Metso T.M., Metso A.J., Kloss M., Debette S. et al. Cervical Artery Dissection and Ischemic Stroke Patients (CADISP) Study Group. Clinical import of Horner syndrome in internal carotid and vertebral artery dissection. Neurology. 2014;82(18):1653–9. https://doi.org/10.1212/WNL.0000000000000381Покаленко Е.А., Кулеш А.А., Дробаха В.Е., Шестаков В.В. Изолированная невропатия подъязычного нерва на фоне диссекции С2 сегмента внутренней сонной артерии: описание клинического случая и обзор литературы. Неврологический журнал. 2019;24(1):42–48. https://doi.org/10.18821/1560-9545-2019-24-1-42-48Pokalenko E.A., Dultsev K.N., Kulesh A.A., Drobakha V.E., Karakulov O.G., Shestakov V.V. Carotid artery stenting in cervical dissection. Russian neurological journal. 2019;(4):23–30. (In Russ.). https://doi.org/10.18821/1560-9545-2019-24-1-42-48Gottesman R.F., Sharma P., Robinson K.A., Arnan M., Tsui M., Ladha K., Newman-Toker D.E. Clinical characteristics of symptomatic vertebral artery dissection: a systematic review. Neurologist. 2012;18(5):245–54. https://doi.org/10.1097/NRL.0b013e31826754e1Gottesman R.F., Sharma P., Robinson K.A., Arnan M., Tsui M., Ladha K., Newman-Toker D.E. Clinical characteristics of symptomatic vertebral artery dissection: a systematic review. Neurologist. 2012;18(5):245–54. https://doi.org/10.1097/NRL.0b013e31826754e1Кулеш А.А., Демин Д.А., Гусева А.Л., Виноградов О.И., Парфенов В.А. Вестибулярное головокружение в неотложной неврологии. Российский неврологический журнал. 2021;26(4):50–59. https://doi.org/10.30629/2658-7947-2021-26-4-50-59Kulesh A.A., Dyomin D.A., Guseva A.L., Vinogradov O.I., Parfyonov V.A. Vestibular vertigo in emergency neurology. Russian neurological journal. 2021;26(4):50–59. (In Russ.). https://doi.org/10.30629/2658-7947-2021-26-4-50-59Bond K.M., Krings T., Lanzino G., Brinjikji W. Intracranial dissections: A pictorial review of pathophysiology, imaging features, and natural history. J Neuroradiol. 2021;48(3):176–188. https://doi.org/10.1016/j.neurad.2020.03.007Bond K.M., Krings T., Lanzino G., Brinjikji W. Intracranial dissections: A pictorial review of pathophysiology, imaging features, and natural history. J Neuroradiol. 2021;48(3):176–188. https://doi.org/10.1016/j.neurad.2020.03.007Hakimi R., Sivakumar S. Imaging of Carotid Dissection. Curr Pain Headache Rep. 2019;23(1):2. https://doi.org/10.1007/s11916-019-0741-9Hakimi R., Sivakumar S. Imaging of Carotid Dissection. Curr Pain Headache Rep. 2019;23(1):2. https://doi.org/10.1007/s11916-019-0741-9Engelter S.T., Rutgers M.P., Hatz F., Georgiadis D., Fluri F., Sekoranja L. et al. Intravenous thrombolysis in stroke attributable to cervical artery dissection. Stroke. 2009;40(12):3772–6. https://doi.org/10.1161/STROKEAHA.109.555953Engelter S.T., Rutgers M.P., Hatz F., Georgiadis D., Fluri F., Sekoranja L. et al. Intravenous thrombolysis in stroke attributable to cervical artery dissection. Stroke. 2009;40(12):3772–6. https://doi.org/10.1161/STROKEAHA.109.555953Engelter S.T., Dallongeville J., Kloss M., Metso T.M., Leys D., Brandt T. et al.; Cervical Artery Dissection and Ischaemic Stroke Patients-Study Group. Thrombolysis in cervical artery dissection-data from the Cervical Artery Dissection and Ischaemic Stroke Patients (CADISP) database. Eur J Neurol. 2012;19(9):1199–206. https://doi.org/10.1111/j.1468-1331.2012.03704.xEngelter S.T., Dallongeville J., Kloss M., Metso T.M., Leys D., Brandt T. et al.; Cervical Artery Dissection and Ischaemic Stroke Patients-Study Group. Thrombolysis in cervical artery dissection-data from the Cervical Artery Dissection and Ischaemic Stroke Patients (CADISP) database. Eur J Neurol. 2012;19(9):1199–206. https://doi.org/10.1111/j.1468-1331.2012.03704.xTsivgoulis G., Zand R., Katsanos A.H., Sharma V.K., Goyal N., Krogias C. et al. Safety and outcomes of intravenous thrombolysis in dissection-related ischemic stroke: an international multicenter study and comprehensive meta-analysis of reported case series. J Neurol. 2015;262(9):2135–43. https://doi.org/10.1007/s00415-015-7829-xTsivgoulis G., Zand R., Katsanos A.H., Sharma V.K., Goyal N., Krogias C. et al. Safety and outcomes of intravenous thrombolysis in dissection-related ischemic stroke: an international multicenter study and comprehensive meta-analysis of reported case series. J Neurol. 2015;262(9):2135–43. https://doi.org/10.1007/s00415-015-7829-xLin J., Sun Y., Zhao S., Xu J., Zhao C. Safety and Efficacy of Thrombolysis in Cervical Artery Dissection-Related Ischemic Stroke: A Meta-Analysis of Observational Studies. Cerebrovasc Dis. 2016;42(3–4):272–9. https://doi.org/10.1159/000446004Lin J., Sun Y., Zhao S., Xu J., Zhao C. Safety and Efficacy of Thrombolysis in Cervical Artery Dissection-Related Ischemic Stroke: A Meta-Analysis of Observational Studies. Cerebrovasc Dis. 2016;42(3–4):272–9. https://doi.org/10.1159/000446004Bernardo F., Nannoni S., Strambo D., Bartolini B., Michel P., Sirimarco G. Intravenous thrombolysis in acute ischemic stroke due to intracranial artery dissection: a single-center case series and a review of literature. J Thromb Thrombolysis. 2019;48(4):679–684. https://doi.org/10.1007/s11239-019-01918-6Bernardo F., Nannoni S., Strambo D., Bartolini B., Michel P., Sirimarco G. Intravenous thrombolysis in acute ischemic stroke due to intracranial artery dissection: a single-center case series and a review of literature. J Thromb Thrombolysis. 2019;48(4):679–684. https://doi.org/10.1007/s11239-019-01918-6Traenka C., Jung S., Gralla J., Kurmann R., Stippich C., Simonetti B.G. et al. Endovascular therapy versus intravenous thrombolysis in cervical artery dissection ischemic stroke — Results from the SWISS registry. Eur Stroke J. 2018;3(1):47–56. https://doi.org/10.1177/2396987317748545Traenka C., Jung S., Gralla J., Kurmann R., Stippich C., Simonetti B.G. et al. Endovascular therapy versus intravenous thrombolysis in cervical artery dissection ischemic stroke — Results from the SWISS registry. Eur Stroke J. 2018;3(1):47–56. https://doi.org/10.1177/2396987317748545Schlemm L., von Rennenberg R., Siebert E., Bohner G., Flottmann F., Petzold G.C. et al. GSR-ET investigators. Mechanical thrombectomy in patients with cervical artery dissection and stroke in the anterior or posterior circulation — a multicenter analysis from the German Stroke Registry. Neurol Res Pract. 2021;3(1):20. https://doi.org/10.1186/s42466-021-00119-ySchlemm L., von Rennenberg R., Siebert E., Bohner G., Flottmann F., Petzold G.C. et al. GSR-ET investigators. Mechanical thrombectomy in patients with cervical artery dissection and stroke in the anterior or posterior circulation — a multicenter analysis from the German Stroke Registry. Neurol Res Pract. 2021;3(1):20. https://doi.org/10.1186/s42466-021-00119-yKaram A., Bricout N., Khyeng M., Cordonnier C., Leclerc X., Henon H., Casolla B. Safety and outcome of mechanical thrombectomy in ischaemic stroke related to carotid artery dissection. J Neurol. 2021;Jun29. https://doi.org/10.1007/s00415-021-10656-wKaram A., Bricout N., Khyeng M., Cordonnier C., Leclerc X., Henon H., Casolla B. Safety and outcome of mechanical thrombectomy in ischaemic stroke related to carotid artery dissection. J Neurol. 2021;Jun29. https://doi.org/10.1007/s00415-021-10656-wMarnat G., Sibon I., Bourcier R., Anadani M., Gariel F., Labreuche J. et al.; ETIS and TITAN Investigators. Thrombolysis Improves Reperfusion and the Clinical Outcome in Tandem Occlusion Stroke Related to Cervical Dissection: TITAN and ETIS Pooled Analysis. J Stroke. 2021;23(3):411–419. https://doi.org/10.5853/jos.2020.04889Marnat G., Sibon I., Bourcier R., Anadani M., Gariel F., Labreuche J. et al.; ETIS and TITAN Investigators. Thrombolysis Improves Reperfusion and the Clinical Outcome in Tandem Occlusion Stroke Related to Cervical Dissection: TITAN and ETIS Pooled Analysis. J Stroke. 2021;23(3):411–419. https://doi.org/10.5853/jos.2020.04889Marnat G., Lapergue B., Sibon I., Gariel F., Bourcier R., Kyheng M. et al.; TITAN and ETIS Investigators*. Safety and Outcome of Carotid Dissection Stenting During the Treatment of Tandem Occlusions: A Pooled Analysis of TITAN and ETIS. Stroke. 2020;51(12):3713–3718. https://doi.org/10.1161/STROKEAHA.120.030038Marnat G., Lapergue B., Sibon I., Gariel F., Bourcier R., Kyheng M. et al.; TITAN and ETIS Investigators*. Safety and Outcome of Carotid Dissection Stenting During the Treatment of Tandem Occlusions: A Pooled Analysis of TITAN and ETIS. Stroke. 2020;51(12):3713–3718. https://doi.org/10.1161/STROKEAHA.120.030038Pinho J., Rocha S., Varanda S., Ribeiro M., Rocha J., Ferreira C. Cerebral hyperperfusion syndrome: a novel presentation of internal carotid artery dissection. Neurology. 2013;81(6):599–601. https://doi.org/10.1212/WNL.0b013e31829e6f26Pinho J., Rocha S., Varanda S., Ribeiro M., Rocha J., Ferreira C. Cerebral hyperperfusion syndrome: a novel presentation of internal carotid artery dissection. Neurology. 2013;81(6):599–601. https://doi.org/10.1212/WNL.0b013e31829e6f26Judy B.F., Theodore N. Bow Hunter’s Syndrome. World Neurosurg. 2021;148:127–128. https://doi.org/10.1016/j.wneu.2021.01.030Judy B.F., Theodore N. Bow Hunter’s Syndrome. World Neurosurg. 2021;148:127–128. https://doi.org/10.1016/j.wneu.2021.01.030Morris N.A., Merkler A.E., Gialdini G., Kamel H. Timing of Incident Stroke Risk After Cervical Artery Dissection Presenting Without Ischemia. Stroke. 2017;48(3):551–555. https://doi.org/10.1161/STROKEAHA.116.015185 Erratum in: Stroke. 2018;49(10):e308.Morris N.A., Merkler A.E., Gialdini G., Kamel H. Timing of Incident Stroke Risk After Cervical Artery Dissection Presenting Without Ischemia. Stroke. 2017;48(3):551–555. https://doi.org/10.1161/STROKEAHA.116.015185 Erratum in: Stroke. 2018;49(10):e308.Gensicke H., Ahlhelm F., Jung S., von Hessling A., Traenka C., Goeggel Simonetti B. et al. New ischaemic brain lesions in cervical artery dissection stratified to antiplatelets or anticoagulants. Eur J Neurol. 2015;22(5):859–65,e61. https://doi.org/10.1111/ene.12682Gensicke H., Ahlhelm F., Jung S., von Hessling A., Traenka C., Goeggel Simonetti B. et al. New ischaemic brain lesions in cervical artery dissection stratified to antiplatelets or anticoagulants. Eur J Neurol. 2015;22(5):859–65,e61. https://doi.org/10.1111/ene.12682Kloss M., Grond-Ginsbach C., Ringleb P., Hausser I., Hacke W., Brandt T. Recurrence of cervical artery dissection: An underestimated risk. Neurology. 2018;90(16):e1372–e1378. https://doi.org/10.1212/WNL.0000000000005324Kloss M., Grond-Ginsbach C., Ringleb P., Hausser I., Hacke W., Brandt T. Recurrence of cervical artery dissection: An underestimated risk. Neurology. 2018;90(16):e1372–e1378. https://doi.org/10.1212/WNL.0000000000005324Kloss M., Kalashnikova L., Dobrynina L., Traenka C., Engelter S.T., Metso T.M. et al. Recurrent versus first cervical artery dissection — a retrospective study of clinical and vascular characteristics. Eur J Neurol. 2020;27(11):2185–2190. https://doi.org/10.1111/ene.14417Kloss M., Kalashnikova L., Dobrynina L., Traenka C., Engelter S.T., Metso T.M. et al. Recurrent versus first cervical artery dissection — a retrospective study of clinical and vascular characteristics. Eur J Neurol. 2020;27(11):2185–2190. https://doi.org/10.1111/ene.14417Traenka C., Grond-Ginsbach C., Goeggel Simonetti B., Metso T.M., Debette S., Pezzini A. et al.; CADISP-Plus Study Group. Artery occlusion independently predicts unfavorable outcome in cervical artery dissection. Neurology. 2020;94(2):e170–e180. https://doi.org/10.1212/WNL.0000000000008654Traenka C., Grond-Ginsbach C., Goeggel Simonetti B., Metso T.M., Debette S., Pezzini A. et al.; CADISP-Plus Study Group. Artery occlusion independently predicts unfavorable outcome in cervical artery dissection. Neurology. 2020;94(2):e170–e180. https://doi.org/10.1212/WNL.0000000000008654Perry B.C., Al-Ali F. Spontaneous cervical artery dissection: the borgess classification. Front Neurol. 2013;4:133. https://doi.org/10.3389/fneur.2013.00133Perry B.C., Al-Ali F. Spontaneous cervical artery dissection: the borgess classification. Front Neurol. 2013;4:133. https://doi.org/10.3389/fneur.2013.00133CADISS trial investigators, Markus H.S., Hayter E., Levi C., Feldman A., Venables G., Norris J. Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): a randomised trial. Lancet Neurol. 2015;14(4):361–7. https://doi.org/10.1016/S1474-4422(15)70018-9CADISS trial investigators, Markus H.S., Hayter E., Levi C., Feldman A., Venables G., Norris J. Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): a randomised trial. Lancet Neurol. 2015;14(4):361–7. https://doi.org/10.1016/S1474-4422(15)70018-9Markus H.S., Levi C., King A., Madigan J., Norris J.; Cervical Artery Dissection in Stroke Study (CADISS) Investigators. Antiplatelet Therapy vs Anticoagulation Therapy in Cervical Artery Dissection: The Cervical Artery Dissection in Stroke Study (CADISS) Randomized Clinical Trial Final Results. JAMA Neurol. 2019;76(6):657–664. https://doi.org/10.1001/jamaneurol.2019.0072Markus H.S., Levi C., King A., Madigan J., Norris J.; Cervical Artery Dissection in Stroke Study (CADISS) Investigators. Antiplatelet Therapy vs Anticoagulation Therapy in Cervical Artery Dissection: The Cervical Artery Dissection in Stroke Study (CADISS) Randomized Clinical Trial Final Results. JAMA Neurol. 2019;76(6):657–664. https://doi.org/10.1001/jamaneurol.2019.0072Engelter S.T., Traenka C., Gensicke H., Schaedelin S.A., Luft A.R., Simonetti B.G. et al.; TREAT-CAD investigators. Aspirin versus anticoagulation in cervical artery dissection (TREAT-CAD): an open-label, randomised, non-inferiority trial. Lancet Neurol. 2021;20(5):341–350. https://doi.org/10.1016/S1474-4422(21)00044-2Engelter S.T., Traenka C., Gensicke H., Schaedelin S.A., Luft A.R., Simonetti B.G. et al.; TREAT-CAD investigators. Aspirin versus anticoagulation in cervical artery dissection (TREAT-CAD): an open-label, randomised, non-inferiority trial. Lancet Neurol. 2021;20(5):341–350. https://doi.org/10.1016/S1474-4422(21)00044-2Caprio F.Z., Bernstein R.A., Alberts M.J., Curran Y., Bergman D., Korutz A.W. et al. Efficacy and safety of novel oral anticoagulants in patients with cervical artery dissections. Cerebrovasc Dis. 2014;38(4):247–53. https://doi.org/10.1159/000366265Caprio F.Z., Bernstein R.A., Alberts M.J., Curran Y., Bergman D., Korutz A.W. et al. Efficacy and safety of novel oral anticoagulants in patients with cervical artery dissections. Cerebrovasc Dis. 2014;38(4):247–53. https://doi.org/10.1159/000366265Kleindorfer D.O., Towfighi A., Chaturvedi S., Cockroft K.M., Gutierrez J., Lombardi-Hill D. et al. 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/ American Stroke Association. Stroke. 2021;52(7):e364–e467. https://doi.org/10.1161/STR.0000000000000375Kleindorfer D.O., Towfighi A., Chaturvedi S., Cockroft K.M., Gutierrez J., Lombardi-Hill D. et al. 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/ American Stroke Association. Stroke. 2021;52(7):e364–e467. https://doi.org/10.1161/STR.0000000000000375Ahmed N., Steiner T., Caso V., Wahlgren N.; ESO-KSU session participants. Recommendations from the ESO-Karolinska Stroke Update Conference, Stockholm 13–15 November 2016. Eur Stroke J. 2017;2(2):95–102. https://doi.org/10.1177/2396987317699144Ahmed N., Steiner T., Caso V., Wahlgren N.; ESO-KSU session participants. Recommendations from the ESO-Karolinska Stroke Update Conference, Stockholm 13–15 November 2016. Eur Stroke J. 2017;2(2):95–102. https://doi.org/10.1177/2396987317699144Patel S.D., Haynes R., Staff I., Tunguturi A., Elmoursi S., Nouh A. Recanalization of cervicocephalic artery dissection. Brain Circ. 2020;6(3):175–180. https://doi.org/10.4103/bc.bc_19_20Patel S.D., Haynes R., Staff I., Tunguturi A., Elmoursi S., Nouh A. Recanalization of cervicocephalic artery dissection. Brain Circ. 2020;6(3):175–180. https://doi.org/10.4103/bc.bc_19_20

The authors declare that there are no conflicts of interest present.