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It is a tear in one of the carotid arteries of the neck, which allows blood under arterial pressure to enter the wall of the artery and split its layers. The result is either an intramural hematoma or an aneurysmal dilatation, either of which can be a source of microemboli, with the latter also causing a mass effect on surrounding structures.
Vertebral artery dissection is a relatively rare but increasingly recognized cause of stroke in patients younger than 45 years. Although the term spontaneous Vertebral artery dissection is used to describe cases that do not involve significant blunt or penetrating trauma as a precipitating factor, many patients with so-called spontaneous Vertebral artery dissectionhave a history of trivial or minor injury involving some degree of cervical distortion.