We report the case of a 42 year old man with a right middle cerebral artery territory infarct secondary to a right internal carotid artery dissection, the likely source of embolic occlusion. This case highlights several important issues concerning the occurrence of cervical artery dissections (CAD) and the complicating role of such events in stroke treatment and management. The patient was followed throughout presentation, acute management and recovery. CAD is one the most common causes of ischemic stroke in young and middle aged patients. Furthermore, spontaneous dissection of the carotid and vertebral arteries have a largely unknown pathogenesis. CAD results in added considerations for the management of stroke that include thrombolysis efficacy, interventional dissection management, antithrombotic therapy, recovery and recurrence. Recognition and improved approaches to management of stroke secondary to CAD are crucial for the care of these patients.
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