ICA and VA dissections

Q: Transient monocular blindness is more common with? (select one) 

A) Internal carotid artery dissection 
B) Vertebral artery dissection 


 Answer: A

 Transient monocular blindness exclusively occurs in internal carotid artery dissection (ICA-D).

Although cerebral and cervical arterial dissections can occur at any age, they are a common cause of stroke in the young, and the most highly associated factor is the strenuous physical activity. Clinically, spontaneous cerebral and cervical artery dissection can be differentiated before imagings can be pursued. Internal carotid artery dissection (ICA-D) is relatively more common in men. The history of infection in the previous week is more common with ICA-D, and the history of cervical trauma in the previous week is more common with vertebral artery dissection (VA-D). Similarly, neck pain is more associated with VA-D. 


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Reference:

Debette S, Grond-Ginsbach C, Bodenant M, et al. Differential features of carotid and vertebral artery dissections: the CADISP study. Neurology 2011; 77:1174.