Clinical manifestations of vertebral artery dissection.

The most frequent clinical manifestation of vertebral artery dissection is posterior headache or neck pain accompanied or followed by posterior circulation transient ischemic attack or stroke. Rarer clinical features include isolated headache or neck pain, cervical spinal cord ischemia and cervical root impairment. Asymptomatic vertebral artery dissections have been reported. In the case of primary intracranial vertebral artery dissection or intracranial extension of an extracranial dissection, subarachnoid hemorrhage and rarely rostral cervical spinal cord ischemia or posterior fossa mass effect may occur.