1. Headache secondary to cervical artery dissections: practice pointers
- Author
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Caterina Marotti, Simone Gallerini, Roberto Marconi, Manuele Bartalucci, Luca Marsili, and Alberto Chiti
- Subjects
Adult ,Male ,medicine.medical_specialty ,Neurology ,Cervical Artery ,Vertebral artery dissection ,Dermatology ,Carotid artery dissection ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,030212 general & internal medicine ,Neuroradiology ,Aged ,Retrospective Studies ,Aged, 80 and over ,Neurologic Examination ,Vertebral Artery Dissection ,business.industry ,Headache ,General Medicine ,Emergency department ,Middle Aged ,medicine.disease ,Surgery ,Psychiatry and Mental health ,International Classification of Headache Disorders ,Female ,Neurology (clinical) ,Neurosurgery ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Cervical artery dissections may present with mild and misleading symptoms such as a headache or cervical pain. In the absence of early diagnosis and therapy, such patients may have a high risk of cerebrovascular events. In order to refine evaluation of cervical artery dissections, we report the experience of a single center, focusing on clinical findings (e.g., headache and pain-related features at onset). From 2012 to 2017, 49 patients with cervical arteries dissections were admitted to our institution; 28 out of 49 patients (57%) presented with a headache or cervical pain, which were evaluated according to the International Classification of Headache Disorders (ICHD-III beta). Item C3a of ICHD-III beta (“pain is severe and continuous for days or longer”) was present in all patients symptomatic for a headache. Another common characteristic was the recent onset, with an average (± SD) timing from the onset of a headache to the first neurologic evaluation of 3 (± 2) days (range 1–5). A refined clinical evaluation of patients presenting with a headache at the Emergency Department could improve the early detection and management of patients with cervical artery dissections, in particular when presenting without other associated neurological symptoms.
- Published
- 2018