Different pain patterns in patients with vertebral artery dissections

Spontaneous or traumatic cervical artery dissections are an increasingly recognized cause of stroke in young adults.1 The internal carotid artery (ICA) is more frequently involved than the vertebral artery (VA).1 Headache and neck pain are common and suggestive symptoms of VA dissection (VAD).2 However, their clinical characteristics and their relationship with focal neurologic symptoms have not been extensively analyzed. We prospectively analyzed 10 consecutive patients admitted to our hospital with diagnosis of VAD from 1995 to 2003. In all cases, the dissection was confirmed by magnetic resonance angiography (MRA), conventional angiography, or both. The presence of headache, neck pain, or both at the time of the dissection, their characteristics, and their association with neurologic signs and symptoms were registered by direct interview. The history of headache was classified according to the International Headache Society criteria.3 Headache at the time of arterial dissection was classified into that occurring before, during …