Table 1.
Summary of the literature regarding post-traumatic internal carotid artery dissection. Studies conducted before 1990 have been excluded.
| References | Number of Cases | Age | Sex | Type of Trauma | Presenting Neurological Symptoms | Trauma - Symptoms Interval | Before Diagnosis Imaging |
Type of ICA
Lesions |
Other Correlated Findings |
|---|---|---|---|---|---|---|---|---|---|
| Martin et al. 1991 | 3 | 15ys | M | MVA | Hemiparesis | - | CT, DUS, angiography | ICAD | - |
| 22ys | F | - | CT, angiography | ||||||
| 43ys | F | angiography | Bilateral ICAD | ||||||
| Romner et al 1994 | 2 | 26ys | M | Wrestling | Altered consciousness, dysphasia, hemiparesis | < 1 day | CT, TCD, angiography, SPECT | ICAD | - |
| 23ys | F | Fall from staircase | Some minutes | MCA infarct | |||||
| Achtereekte et al. 1994 | 1 | 48ys | 1 M | Bicycle accident (blunt head trauma) | Transient loss of consciousness, aphasia, concentration disturbances, short-term memory loss | < some hours | Skull CT, TCD, DUS, angiography | ICAD with saccular aneurysm | Hematoma and bruise of the frontal area; Right MCA blood flow decrease |
| Fletcher et al. 1995 | 1 | 31ys | 1 M | Jockey fall (jaw and neck injury) | Loss of consciousness (soon recovered), Horner’s syndrome | < some hours | Neck X-rays, head CT | Left ICAD with complete occlusion | Left MCA infarct, left vertebral artery occlusion |
| Horner’s syndrome, major convulsive seizure, aphasia, hemiplegia | 4 days | Head CT, angiography | |||||||
| Sanzone et al. 1995 | 2 | 27ys | 2 M | Assault with a lead pipe | Loss of consciousness, hemiplegia, fixed dilated left pupil | < 1 day | Facial X-rays, head CT, angiography |
ICA tapering | MCA and ACA infarct |
| 39ys | Hemiplegia and hemianopsia | 1 day | |||||||
| Lemmerling et al. 1996 | 1 | 50ys | 1 M | Car accident | Dysarthria, difficult swallowing and hypoglossal nerve dysfunction | < some hours | Neck CT, MRA | ICAD | - |
| Laitt et al. 1996 | 8 | 35.9ys (range 21-52) | 5 M, 3 F | MVA (6), assault (1), horse fall (1) | Hemiparesis or hemiplegia (8), dysphasia or aphasia (4) | 4 hours up to 75 days | Brain CT, angiography, MRI and MRA (1) | ICAD (7), ICA pseudoaneurysm (1) | Cerebral infarct (7) |
| Alimi et al. 1996 | 7 | 35.7ys (range 21-59) | 3 M, 4 F | MVA (6), cervical manipulation (1) | Hemiparesis (2), hemiplegia (2), aphasia (2), Horner’s syndrome (1), oculomotor disturbances (1), recurrent TIAs (1) | < some hours | CT (7), doppler arteriography (5), arteriography (2) | Unilateral ICAD (3) with controlateral thrombosis (2), bilateral ICAD (1), false aneurysm (2), tight stenosis (1) | Cerebral infarct or hypodense cerebral lesions (6) |
| Pica et al. 1996 | 1 | 31ys | F | Car accident (restrained passenger) | Right retroorbital headache, right-sided tongue deviation, dysarthria | 4 months | Head and neck CT, lumbar puncture, MRI and MRA | Right ICAD with intramural hematoma | ICA tortuosity |
| Sidhu et al. 1996 | 1 | 17mo | M | Soft palate injury | Seizures | 48 hours | MRI, MRA | ICAD | Soft palate abrasion; cerebral infarct |
| Duke et al. 1997 | 6 | 29.5ys (range 19-40) | 3 M, 3 F | MVA | Horner’s syndrome (1), hemiparesis (2), no symptoms (4) |
< 2 hours up to 5 days | Head CT, angiography | ICAD (3), ICA intimal flap (1), ICA pseudoaneurysm (3) | Cerebral infarcts (2) |
| Matsuura et al. 1997 | 1 | 20ys | 1 F | MVA (no seat belt) | Carotidynia, unilateral oculosympathetic paresis, unilateral loss of limbs sensation, hemiparesis | 3 days | Cervical spine X-rays (soon after the accident), arteriography | Right ICAD at C1 level with pseudoaneysysm | - |
| Vishteh et al. 1998 | 13 | 30,6ys (range 12-71) | 9 M, 4 F | Blunt trauma (11), gunshot (1), stab (1) | Hemiparesis (11), cranial nerve deficits (2), aphasia (2), Hornes’s syndrome (2), focal seizure (1) | within some hours or later after hospital discharge | Brain CT (11), brain MRI (3), angiography (all) | ICAD (9 cervical, 3 distal cervical and petrous, 3 cavernous, and 1 petrous segments), plus occlusion (7), dissecting aneurysm (6), and rupture with carotid-cavernous fistula formation (2) | Cerebral contusion (5), elevated intracranial pressure (4), basal cranial fractures (5), vertebral fracture (2) |
| Alimi et al. 1998 | 8 | 35,2ys (range 17-54) | 3 M, 5 F | MVA (6 in car, 4 of which with seatbelt fastened; 1 moped), stairway fall (1) | Neurological deficit (3) plus aphasia (1), unconsciousness (6), hemiplegia (2) | < some hours up to 13 days |
Brain CT, DUS (4), angiography | Bilateral ICAD (8), with or without stenosis, dilatation, or thrombosis | Unilateral cerebral infarction (5), bilateral cerebral infarction (3), plus haemorrhagic cerebral contusion (2) |
| Kumar et al. 1998 | 1 | 45ys | 1 M | Vomiting | hemiplegia, one eye loss of vision, slurred speech, a decrease of consciousness | About 18 hours | Head CT, DUS, brain MRI | Bilateral ICAD, one side with occlusion, other side only intimal flap | ACA and MCA’s infarct |
| Gouny et al. 1998 | 1 | 39ys | 1 M | Motorcycle accident | Unilateral anisocoria and mydriasis, hemiplegia | < some hours | Brain CT, cervical echography, MRI | Bilateral ICAD with bilateral thrombosis | - |
| Schievink et al. 1998 | 4 | 35ys (range 31-39) | 3 M, 1 F | Softball neck direct impact (2), car accidents (2) | None (only the softball cases are described) | - | Head CT, angiography | ICAD with intimal flap, aneurysm, maybe thrombosis | - |
| Monolateral ptosis and miosis (only the softball cases are described) | 3 days | DUS, MRA | ICAD | - | |||||
| Simionato et al. 1999 | 1 | 39ys | 1 M | Car accident (craniofacial trauma) | Hemiparesis | < some hours | Head CT and MRI, MRA, digital subtraction angiography | ICAD with aneurysm and obstruction | Fronto-insular and deep hemisphere infarct |
| Babovic et al. 2000 | 1 | 43ys | 1 F | Car accident (seatbelt fastened, airbag deployment) | Unilateral progressive visual loss | 10 days | Orbits CT, fundus oculi examination, head CT, head MRI and MRA | Bilateral ICAD with bilateral thrombus | Closed head injury and facial fractures; frontal lobe infarct |
| Duncan et al. 2000 | 1 | 39ys | 1 M | Car accident (seatbelt fastened, airbag deployment) | Hemiplegia | < some hours | Brain CT, angiography | Bilateral ICAD with thrombus in the right ICA | fibromuscular ICA dysplasia; parietal lobe infarct with later haemorrhage |
| Busch et al. 2000 | 1 | 27ys | 1 F | Motorcycle accident | Progressive loss of consciousness | Several hours | Brain CT, angiography | Bilateral ICAD | VAD; cerebral infarct |
| Hughes et al. 2000 | 7 | - | - | Severe blunt head trauma | None (incidental finding) | - | Cervical spine/brain MRI (6), angiography (1) | ICAD | - |
| Lee and Jensen 2000 | 1 | 43ys | 1 F | Bicycle ride (no fall or accident) | Acute headache | < some hours | - | Bilateral extracranial ICAD with bilateral hematomas and pseudoaneurysms and stenosis | bilateral poor disc and cup margins, small inferotemporal cotton-wool spot in the left eye |
| persistent headache, transient visual disturbances such as unilateral scotoma and “granular” vision, transient complete blindness, unilateral ptosis and anisocoria | 1 day | Head CT (normal at day 2), ophthalmoscopic examination (day 9), dilated funduscopic examination, MRI and MRA (day 11) | |||||||
| Malek et al. 2000 | 2 | 37ys | 2 F | Strangulation | Upper limbs weakness, leg numbness, and dysphasia |
- | - | ICAD | - |
| 44ys | MVA (whiplash injury) | Dysphasia, unilateral upper limb weakness and numbness |
|||||||
| Scavée et al. 2001 | 1 | 53ys | M | MVA | Neck pain and dizziness | 6 weeks | CT, angiography, MRI | ICA pseudoaneurysm with intramural thrombus | - |
| Windfuhr 2001 | 1 | 5ys | F | Pharynx penetrating injury | Oral bleeding and anemia | 9 days | Angiography | ICAD with aneurysm | 3 mm pharyngeal lesion |
| McNeil et al. 2002 | 1 | 18ys | M | Gunshot | Not appreciable (sedated) | - | Head, face, and cervical spine CT, angiography | ICA pseudoaneurysm | Distal embolic angular artery occlusion |
| Duane et al. 2002 | 2 | 31ys | F | Strangulation and stabbing attempt | Seizure, tongue deviation | 8 days | Neck CT, angiography | ICA pseudoaneurysm | peritonsillar abscess |
| 27ys | F | Gun shot | - | - | Head x-ray, angiography | ICA AVF with pseudoaneurysm | - | ||
| Blanco Pampin et al. 2002 | 2 | 19ys | M | Car accident | Confusion, speech difficulties, unilateral facial nerve paralysis, and unilateral hemiplegia |
48 hours | Head CT, DUS, angiography | ICAD with thrombosis | Neck bruise and cerebral infarct |
| - | - | 33ys | F | Hanging attempt | Loss of consciousness and unilateral hemiplegia | 6 hours | Head CT | ICAD | Neck bruise and cerebral infarct with C2 odontoid fracture |
| Men et al. 2003 | 1 | 48ys | M | MVA | - | Few weeks | Angiography | ICAD with AVF | - |
| Pary and Rodnitzky 2003 | 1 | 43ys | M | Taekwondo training | Headache, transient visual disturbances, unilateral hemisensory loss and hemiparesis, Wernicke’s aphasia | < some hours | Head CT, brain MRI, MRA | ICAD with hematoma | MCA infarct |
| Fusonie et al. 2004 | 1 | 37ys | M | Car accident | One upper limb weakness episodes | 15 years | Cervical MRI, MRA | ICA pseudoaneurysm | - |
| Fanelli et al. 2004 | 1 | 17ys | 1 M | Motorcycle accident | Hemiplegia and positive Babinski’s sign | < some hours | Head CT | Bilateral ICAD | Right hemisphere cerebral infarct |
| Payton et al. 2004 | 1 | 11ys | 1 M | Playing accident (hitting head or neck to a padded wall) | Dysarthria, lethargy, ocular deviation, hemiplegia | < some hours | Multiple X-rays, head and cervical spine CT, head MRI and MRA | Bilateral ICAD | - |
| Fateri et al. 2005 | 1 | 52ys | 1 M | Car accident | Altered consciousness, hemisyndrome | < some hours | Craniocervicalthoracic CT | ICAD with tight stenosis and luminal thrombosis | Cerebral arteries’ filling defects related to thromboembolic events |
| Clarot et al. 2005 | 2 | 38ys | 1 M | Attempted strangulation | Altered consciousness, bilateral Babinski’s sign, permanent eye elevation, bradycardia, and right hemiparesis |
Hospital admission (not known the time from the trauma) | Brain CT, DUS | Bilateral CAD with bilateral thrombus and right ICAD and ECAD | Neck ecchymosis and abrasions; cerebral infarct and subarachnoid haemorrhage |
| 42ys | 1 F | Headache | 2 days | DUS, brain CT | Bilateral CAD | - | |||
| Cohen et al. 2005 | 10 | 42.7ys (range 17-62) | 8 M, 2 F | Multiple (6) or cranio-cervical trauma (4), with penetrating injury (2) | Signs of ischaemic stroke, TIA, carotidynia, Horner’s syndrome | 4 hours uo to 19 days | Brain CT, angiography | ICAD | - |
| Cothren et al. 2005 | 46 | 32±2 ys | 65% M, 35% F | MVA, falls, skiing injuries |
Not specified, 38 patients asymptomatic, 8 patients symptomatic | - | Angiography | Pseudoaneurysm | - |
| Joo et al. 2005 | 4 | 28.5ys (range 19-38) | 4 M | Blunt trauma (3) | Limb weakness (2), none (1) | - | CT, MRI, arteriography | Extracranial ICA pseudoaneurysm | - |
| Stab wound (1) | Limb weakness, pulsatile swelling and bruit | Extracranial ICA pseudoaneurysm with ICA-internal jugular vein AVF | |||||||
| de Borst et al. 2006 | 1 | 13ys | 1 F | Bicycle-motor vehicle accident | Hemiplegia with unilateral facial palsy, ipsilateral hemianopia | < some hours and few days after | Brain CT, brain MRI, and MRA | Bilateral ICAD | Unilateral ACA infarct |
| Chokyu et al. 2006 | 1 | 61ys | 1 F | Accidental strangulation | Hemiparesis, unilateral facial palsy | 1 day (soon after the trauma she also had tetraparesis due to spinal cord injury) | Brain CT, cervical MRI, MRA | Bilateral CCAD | Unilateral cerebral infarct |
| Yang et al. 2006 | 3 | 22ys | 3 M | Fall (1) | Altered consciousness, hemiparesis | 2 days | Brain CT, neck CTA, DUS | ICA thrombus and caliber narrowing | Neck abrasion and bruit |
| 47ys | MVA (2) | Altered consciousness | < some hours | Brain CT, cervical X ray, angiography | ICAD | Frontal scalp laceration, some cranial and C2 fractures, pneumocranium, subarachnoid hemorrhage | |||
| 48ys | Altered consciousness, visual acuity reduction, extraocular movements alteration, hemiparesis | 7 days | Brain and facial CT, angiography | Multiple craniofacial fractures, haemorragic ACA and MCA infarct | |||||
| Jariwala et al. 2006 | 1 | 17ys | F | Car accident | Progressive consciousness alteration, hemiparesis and sensation loss | < some hours | Brain and neck spine CT | ICAD | MCA and partially PCA infarct |
| Brain CT, MRI, MRA | |||||||||
| Pierrot et al. 2006 | 2 | 4,5ys | 2 F | Soft palate injury (with oral bleeding) | Altered consciousness, hemiplegia, central facial palsy, aphasia | 24 hours | Brain CT and MRI | ICAD with parietal thrombus | Insular cortex infarct |
| 3,5ys | - | < some hours | - | ||||||
| Lin et al. 2007 | 1 | 7ys | 1 M | Playing at a water park | Head and neck pain, vomiting, hemiparesis, Babinski’s sign, hemifacial palsy with slurred speech and uvula deviation | < some hours | Brain CT, MRI, MRA, angiography | ICAD | Acute cerebral infarct |
| Lo et al. 2007 | 10 | 29.7ys (range 16-57) | 7 M, 3 F | MVA (2), unspecified (8) | Altered consciousness (2), unspecified (8) | - | Brain CT, CTA, | ICA pseudoaneurysm | Craniofacial fractures |
| Zhou et al. 2007 | 1 | 28ys | 1 M | Bungee jumping (no fall) | Right arm paraesthesia | < some hours | Neck US, brain MRI, MRA | ICAD with intramural haematoma | - |
| Schulte et al. 2008 | 2 | 27 and 39ys | 1 M, 1 F | Blunt neck trauma |
TIA, headache, vertigo | - | DUS, CTA | CAD | - |
| Fuse et al. 2008 | 1 | 42ys | M | Neck injury dropping a heavy load | - | - | Head and neck MRI, angiography, single photon emission CT | ICAD | Tracheal fracture, recurrent transient bilateral nerve paralysis; cerebral infarct, |
| Flaherty and Flynn 2008 | 1 | 34ys | F | Hand assault (hit on the face) | Horner’s syndrome | 4 days | Brain CT, neck CTA | ICAD | - |
| Vadikolias et al. 2008 | 1 | 48ys | M | Intense jackhammer use | Hemiparesis | < some hours | Brain CT, DUS, TCD | ICAD | MCA infarct with haemorrage |
| Moriarty et al. 2009 | 1 | 10mo | F | Soft palate injury | Altered consciousness and progressive hemiplegia (no oral bleeding) | 1 day | Brain CT, brain and neck MRI, neck and intracranial MRA | ICAD with thrombus | MCA infarct with haemorrhage, MCA thrombus |
| Molacek et al. 2012 | 1 | 49ys | F | Strangulation attempt | Altered consciousness | - | Brain and neck CTA | Bilateral ICAD | Neck strangulation groove |
| Keilani et al. 2010 | 1 | 52ys | F | Horse riding fall and multiple injuries | Altered consciousness | 1 day (at admission, she had several other lesions which required surgery) | Brain MRI, angiography | ICAD with pseudoaneurysm | Multiple cerebral infarcts |
| Stager et al. 2011 | 1 | 55ys | F | MVA | - | - | CTA, angiography with IVUS | ICAD | Several other lesions, no brain injury |
| Herrera et al. 2011 | 14 | - | - | Gunshot and stab injuries | Bleeding, pulsatile mass, neck bruit, hematoma, stroke, dementia syndrome | - | - | Pseudoaneurysm, AVF, dissection, active bleeding | - |
| Fridley et al. 2011 | 1 | 40ys | M | Wakeboarding | Headache, hemiplegia | 1 day | Head CT, MRI, MRA, angiography | ICAD | Unilateral basal ganglia and internal capsule infarct |
| Taşcılar et al. 2011 | 1 | 31ys | M | Football (neck struck by the ball) | Altered consciousness, hemifacial paresis, hemiplegia, aphasia, positive Babinski’s sign | < 6 hours | CT, DUS, MRA | ICAD | MCA infarct |
| van Wessem et al. 2011 | 5 | 20ys | 2 F | Car accident | Altered consciousness | < some hours | Head and cervical CT, DUS, CTA | ICAD | C0 condyle fracture, MCA infarct |
| 49ys | Altered consciousness, legs paralysis and sensory loss | Brain CT, CTA and angiography | Multiple spine fractures, right temporal lobe hematoma |
||||||
| 19ys | 1 M | Altered consciousness | Brain and cervical CT and CTA | Multiple facial, C0 condyle, skull base fractures, MCA infarct | |||||
| 53ys | M | Truck accident | Sudden decrease of consciousness, hemiparesis, unilateral Babinski’s sign | < some hours | Brain and neck CT | Bilateral C0 fracture, MCA infarct | |||
| 19ys | M | Motorbike accident | Altered consciousness, different blood pressure between the arms | < some hours | Aortic CTA | - | Multiple cranial and skull base fractures, multiple intracerebral hematomas, ACA and MCA infarct |
||
| Still altered consciousness, spontaneous bilateral stretching of both arms and hemiparesis | 7 and 8 days | Brain CT and CTA | |||||||
| Cohen et al. 2012 | 23 | 44ys (range 17-66) | 19 M, 4 F | Multiple trauma (11), penetrating neck injury (2), minor cervico-cranial trauma (10) | Ischaemic stroke symptoms (14), TIA (3), Horner’s syndrome (1), carotidynia (1) | 2 hours up to 21 days | Head and neck CT, CTA (all) | ICAD | - |
| Makhlouf et al. 2013 | 1 | 60ys | 1 F | Hand assault (hit on the head) | Headache | < some hours | Cervical X-rays | ICAD with pseudoaneurysm | Unilateral corona radiata infarct |
| Unilateral facial palsy and Horner’s syndrome | 3 months | Brain MRI and MRA | |||||||
| Prasad et al. 2013 | 1 | 22ys | F | MVA | Altered consciousness | < some hours | Head CT, angiography | ICAD with AVF | Multiple facial fractures, subarachnoid haemorrhage, cerebral oedema |
| Seth et al. 2013 | 47 | 34ys (range 17-71) | 32 M, 15 F | Blunt (47) and penetrating (6) injuries | - | - | CT or conventional angiography | Unilateral (41) and bilateral (6) ICAD with or without pseudoaneurysm | - |
| Hostettler et al. 2013 | 1 | 47ys | 1 M | Softball blunt injury | Neck and head pain, amaurosis fugax, Horner’s syndrome | 1 week | Brain CT, DUS, MRA | ICAD with mural thrombus | - |
| Orman et al. 2013 | 5 | 3.6ys | F | Fall | Hemiplegia, aphasia | - | CT, MRI and/or CTA/MRA | ICAD | Cerebral infarct (3) |
| 7.6ys | M | Head trauma | - | ||||||
| 3.1ys | M | MVA | Focal seizure | ||||||
| 1.9ys | F | Head trauma | Altered mental state | ||||||
| 1ys | M | Fall | Unilateral hypoesthesia | ||||||
| Kalantzis et al. 2014 | 1 | 39ys | 1 M | Snowboarding fall | Horner’s syndrome, periocular and neck pain | 2 days | Head and neck CT, MRI, MRA | ICAD | - |
| Correa and Martinez 2014 | 1 | 41ys | 1 M | Blunt head and neck trauma | Transient loss of consciousness | < some hours | - | ICAD with stenosis | Neck abrasion, carotid bruit; acute cerebral infarct |
| Headache, unilateral visual loss, hemiparesis, unilateral hyperreflexia and Babinski’s sign | 48 hours | Brain CT, MRI, angiography | |||||||
| Crönlein et al. 2015 | 1 | 28ys | 1 F | Car accident | Altered consciousness, head pain, anisocoria | < some hours | Total body CT | Bilateral ICAD | Unilateral central region cerebral infarct |
| CTA, US | |||||||||
| Uhrenholt et al. 2015 | 1 | 42ys | 1 M | Sudden braking | Neck pain, headache, cramps, gradually altered consciousness | < some hours | Brain CT, (PMCT) | ICAD with pseudoaneurysm and mural thrombus | Subarachnoid haemorrhage |
| Morton et al. 2016 | 39 | 41ys | 22 M, 17 F | - | - | - | Head and neck CTA | ICA pseudoaneurysm (bilateral in 4 cases) | Cerebral infarct (7) |
| Griessenauer et al. 2016 | 2 | 21ys | 1 M, 1 F | MVA | Altered consciousness | < some hours | Head CT, CTA | ICA aneurysm | Cranial and facial fractures, intracranial haemorrhage |
| Taoussi et al. 2017 | 1 | 29ys | F | Car accident | Dysphasia, upper limb hemiparesis, | < 12 hours | MRI | Bilateral ICAD | Multiple cerebral infarct |
| Cebeci et al. 2018 | 1 | 10ys | 1 M | Trivial shoulder trauma | Headache, speech impairment, vomiting, and facial paralysis | 6 hours | Head MRI and MRA | ICAD | . |
| Ariyada et al. 2019 | 1 | 23ys | 1 M | Pedestrian run over | Altered consciousness (recovered in some hours) | < some hours | Whole body CT | - | Thin subdural hematoma, odontoid process, pelvis, and limbs’ fracture |
| Bleariness | 1 month | CT angiography, MRA, DSA | Bilateral ICAD | VAD with thrombus | |||||
| Gabriel et al. 2019 | 1 | 37ys | 1 F | CrossFit training | Headache, dizziness, neck pain, unilateral amaurosis fugax | 1 hour | Cervical and chest X-ray, DUS, brain CT, MRI, angiography | Bilateral ICAD | Unilateral corona radiata infarct |
| Hemiplegia, dyslalia, aphasia, dysphagia, unilateral facial droop | 48 hours | ||||||||
| Petetta et al. 2019 | 1 | 44ys | M | Motorcycle accident | Altered consciousness, traumatic shock | < some hours | Whole body CT | - | Several other lesions, no brain injury |
| Altered consciousness | 5 days | Brain CT, MRI, CTA | Bilateral ICAD with intraluminal thrombus | Multiple cerebral infarct | |||||
| Wang et al. 2020 | 6 | 52.67 ys (range 43-62) | 5 M, 1 F | Car accident (2), motorcycle accident (2), fall from height (1), blunt head injury (1) | Paralysis (2), altered consciousness (2), headache (1), neck pain (1) | 4-45 hours | CT, CTA, DUS, DSA, MRI, TCD in various combinations | ICAD | Cerebral infarct (6) |
| Total articles 77 | Total subjects 334 | Mean age 18.9ys | 200 M 113 F | Total articles 77 | - | - | - | - | - |
Abbreviations: ACA indicates anterior cerebral artery; AVF, arteriovenous fistula; CA, cerebral artery; CAD, carotid artery dissection; CCAD, common carotid artery dissection; CT, computer tomography; CTA, computer tomography angiography; DSA, digital subtraction angiography; DUS, duplex ultrasonography; ECAD, external carotid artery dissection; GCS, Glasgow Coma Scale; ICA, internal carotid artery; ICAD, internal carotid artery dissection; IVUS, intravascular ultrasound; MCA, middle cerebral artery; MRA, magnetic resonance angiography; MRI, magnetic resonance imaging; MVA, motor vehicle accident; PMCT, post-mortem computer tomography; TIA, transient ischaemic attack; TCD, transcranial doppler sonography; VAD, vertebral artery dissection.