The EM Educator Series: Cervical Vessel Dissection

Author: Alex Koyfman, MD (@EMHighAK) // Reviewed by: Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER)

Welcome back to the EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed.

This week has another downloadable PDF document with questions, links and answers you can share with learners as educators in #MedEd. Please message us over Twitter and let us know if you have any feedback on ways to improve this for you. Enjoy!


Case 1:

A 32-year-old male presents with headache and neck pain. This is his second visit in the last week. 10 days ago he was in a motor vehicle accident and had a negative non contrast head CT and C spine CT at that time.

Case 2:

A 38-year-old female presents with anterior neck pain. You notice ptosis and miosis on exam, but no anhydrosis.

Case 3:

A 31-year-old female presents with focal motor weakness in the left arm and leg. Her husband states she was complaining of a headache and neck pain several days ago.  A “Code Stroke” is activated.

 

Considerations:

  • What’s the pathophysiology behind cervical vessel dissection?
  • Who is at risk for the condition?
  • How can patient’s present, and what should be on your differential?
  • What is the ED evaluation?
  • What is the ED management?
  • What are the complications if the condition is left untreated?

 

Suggested Resources:

 

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