SynthesisThe neurologist2012
Clinical characteristics of symptomatic vertebral artery dissection: a systematic review.
Synthesis in The neurologist, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
66 citing papers in PubMed, 2 syntheses or guidelines pooled it, 176 citations in OpenAlex.
- Migraine and the risk of cervical artery dissection: A systematic review and meta-analysis.European stroke journal · 2023Pooled it
- Headache in cervicocerebral artery dissection.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2020Pooled it
- Association between spinal manipulative therapy and cervical artery dissection in patients with neck pain or headache: a retrospective cohort study.Chiropractic & manual therapies · 2026Article
- Educational approaches to the relationship between cervical adjusting and risk of cervical artery dissection; a survey of chiropractic faculty.Chiropractic & manual therapies · 2026Article
- Painless vertebral artery dissection mimicking benign paroxysmal positional vertigo: a case report.Annals of medicine and surgery (2012) · 2026Article
- Possible Diagnostic Error in Cervical Artery Dissection: Analysis of STOP-CAD Study.Journal of the American Heart Association · 2026Article
- Cumulative Incidence of Stroke Disability and Mortality Following Emergency Department Discharge for Dizziness: A Cohort Study.Annals of emergency medicine · 2026Article
- Post-stroke headache: a review of epidemiology, pathophysiology, and clinical management.Frontiers in neuroscience · 2026Review
- Acute Vertigo, Dizziness and Imbalance in the Emergency Department-Beyond Stroke and Acute Unilateral Vestibulopathy-A Narrative Review.Brain sciences · 2025Review
- Recognition of Vertebral Artery Dissection in a High-Risk Postpartum Patient by a Chiropractic Physician.Cureus · 2025Article
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- Spontaneous bilateral vertebral artery dissection complicated by hemodynamic posterior circulation stroke: A case report.Radiology case reports · 2025Article
- Diagnostic Errors in the Acutely Dizzy Patient-Lessons Learned.Brain sciences · 2025Review
- Unique Presentation of Vertebral Artery Dissection: A Case Report.HCA healthcare journal of medicine · 2025Article
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- Development of a diagnostic support tool for predicting cervical arterial dissection in primary care.The Journal of manual & manipulative therapy · 2024Observational
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- Plausible Mechanisms of Causation of Immediate Stroke by Cervical Spine Manipulation: A Narrative Review.Cureus · 2024Review
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6 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundVertebral artery dissection (VAD) is an important cause of stroke in the young. It can present nonspecifically and may be misdiagnosed with adverse consequences. We assessed the frequency of head/neck pain, other neurological symptoms, and cerebrovascular events in symptomatic VAD.
methodsWe conducted a systematic review of observational studies, searching electronic databases (MEDLINE, EMBASE) for English-language manuscripts with >5 subjects with clinical or radiologic features of VAD. Two independent reviewers selected studies for inclusion; a third adjudicated differences. Studies were assessed for methodological quality, and clinical data were abstracted. Pooled proportions were calculated.
resultsOf 3996 citations, we screened 511 manuscripts and selected 75 studies describing 1972 VAD patients. The most common symptoms were dizziness/vertigo (58%), headache (51%), and neck pain (46%). Stroke was common (63%), especially with extracranial dissections (66% vs. 32%, P<0.0001), whereas transient ischemic attack (14%) and subarachnoid hemorrhage (10%) were uncommon. Subarachnoid hemorrhage was seen only with intracranial dissections (57% vs. 0%, P=0.003). Fewer than half of the patients had obvious trauma, and only 7.9% had a known connective tissue disease. Outcome was good (modified Rankin scale 0 to 1) in 67% and poor (modified Rankin scale 5 to 6) in 10% of patients.
conclusionsVAD is associated with nonspecific symptoms such as dizziness, vertigo, headache, or neck pain. Ischemic stroke is the most common reported cerebrovascular complication. VAD should be considered in the diagnostic assessment of patients presenting with dizziness or craniocervical pain, even in the absence of other risk factors. Future studies should compare clinical findings as predictors in well-defined, undifferentiated populations of clinical VAD suspects.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.