Table 1.

Summary table for Spontaneous Carotid Artery Dissection.

Etiology	Tear in the intima along vasa vasorum
Incidence	2.5–3 per 100,000
Gender ratio	M>F
Age predilection	40s
Risk factors	Hyperhomocysteinemia, manipulative therapy of the neck, α-1 antitrypsin deficiency, connective tissue disease, genetic abnormalities
Treatment	Antithrombotics/anticoagulation Endovascular stenting
Prognosis	<5% mortality 75% recovery of function if progression to stroke
Imaging findings	Catheter Angiography: Vascular wall abnormality with arterial filling defect, classically flame shaped and absent distal vessels CT Angiography: Filling defect in the affected vessel, classically flame shaped, with distal hypodensity MR Perfusion (PWI) + Diffusion-weighted imaging (DWI) Reversible ischemia: DWI/PWI mismatch; restriction of cerebral blood flow, cerebral blood volume, and increase time to peak flow in the area of reversible ischemia without diffusion restriction Irreversible ischemia: No DWI/PWI mismatch; restriction of cerebral blood flow, cerebral blood volume, and increase time to peak flow in the area of reversible ischemia with diffusion restriction MR Perfusion + DWI + Susceptibility-weighted imaging (SWI) Stage I hemodynamic failure: DWI/PWI mismatch without increased prominence of the venous vasculature Stage II hemodynamic failure (misery perfusion): Increased prominence of the venous vasculature in the area of DWI/PWI mismatch Irreversible ischemia: Diffusion restriction with decreased blood flow (no DWI/PWI mismatch), and prominence of the venous vasculature on SWI