Vertebral artery dissection (VAD) is a medical condition characterized by a tear in the inner lining of the vertebral artery, which is one of the major arteries supplying blood to the brain. This condition can lead to the formation of a blood clot, or thrombus, at the site of the tear, which can subsequently reduce or block blood flow to the brain, potentially resulting in a stroke. The vertebral arteries are located in the neck and travel through the cervical vertebrae, joining to form the basilar artery at the base of the skull. This vascular network is crucial for supplying oxygenated blood to the posterior part of the brain, including the brainstem and cerebellum.

VAD can occur spontaneously or as a result of trauma. Spontaneous dissections may be associated with underlying connective tissue disorders, such as Ehlers-Danlos syndrome or Marfan syndrome, which can weaken the arterial walls. Traumatic dissections can result from neck injuries, such as those sustained in car accidents, sports activities, or even chiropractic manipulations. The condition is more common in young and middle-aged adults and can present with a variety of symptoms, depending on the severity and location of the dissection.

Common symptoms of vertebral artery dissection include sudden onset of neck pain or headache, often described as severe and localized to the back of the head. Patients may also experience dizziness, vertigo, double vision, or difficulty speaking. In some cases, there may be neurological deficits, such as weakness or numbness on one side of the body, reflecting a stroke in the posterior circulation of the brain.

Diagnosis of VAD typically involves imaging studies, such as magnetic resonance imaging (MRI) or computed tomography (CT) angiography, which can visualize the dissection and assess blood flow in the vertebral arteries. Treatment aims to prevent stroke and manage symptoms. Anticoagulant or antiplatelet medications are commonly used to prevent clot formation and reduce the risk of stroke. In severe cases, surgical intervention or endovascular procedures may be necessary to repair the artery or restore blood flow.

The prognosis for individuals with vertebral artery dissection varies. Many patients recover fully with appropriate treatment, but some may experience long-term neurological deficits or recurrent strokes. Early diagnosis and management are crucial to improving outcomes and minimizing complications. Awareness of the condition and its potential triggers is important for prevention, especially in individuals with known risk factors or a history of neck trauma.