Carotid artery dissection

Among the large variety of cerebrovascular syndromes, carotid artery dissec tions remain often under-recognized. Many patients present with minor or tr ansient symptoms, some with local pain only, and some are asymptomatic. A u seful rule is that the coincidence of any local pain in neck or face with a n ipsilateral Homer's syndrome preceding transient or persistent retinal or cerebral ischemic symptoms should alert physicians-notably those treating emergencies-to rule out an underlying dissection of the ipsilateral carotid artery. In most cases the extracranial part of the carotid artery is affec ted; therefore, this review will focus on this main subgroup of patients. W e review the pathological anatomy, as well as possible underlying causes, c linical features, diagnostic tools, differential diagnosis, treatment optio ns, and outcome data.