How is vertebral artery dissection (VAD) treated?

Updated: Feb 21, 2019
  • Author: Eddy S Lang, MDCM, CCFP(EM), CSPQ; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Acute management of proven or suspected spontaneous VAD is as follows [13] :

  • Anticoagulants and antiplatelet agents are the drugs of choice to prevent thromboembolic disorders; the data suggest no difference between the two modalities on outcomes and adverse effects

  • More potent agents (eg, intra-arterial thrombolytics) have been used in selected cases; there may be a role for these medications during acute ischemic events

  • Endovascular and surgical treatments are reserved for patients with concomitant complications or whose maximal medical therapy is unsuccessful

See Treatment and Medication for more detail.

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