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Carotid Dissection – Antithrombotic Duration — SCE Neurology MCQ

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HardCerebrovascular DiseaseCarotid Dissection – Antithrombotic DurationSCE Neurology

A 43-year-old has a small posterior-circulation infarct caused by extracranial vertebral artery dissection. There is no intracranial extension, subarachnoid haemorrhage or competing indication for anticoagulation. Which antithrombotic plan is most consistent with UK stroke guidance?

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Correct answer: C — Antiplatelet or anticoagulant treatment for at least three months, selected by the risk balance

For extracranial cervical artery dissection causing stroke, either antiplatelet or anticoagulant treatment is reasonable for at least three months. The choice is individualised because neither strategy is universally superior. The ordinary 21-day minor-stroke dual-antiplatelet regimen does not replace the dissection-specific minimum duration. A fixed six-week heparin course, mandatory 12-month anticoagulation and routine acute stenting all add unsupported agent, duration or intervention requirements.

Reference: National Clinical Guideline for Stroke, acute care: https://www.strokeguideline.org/chapter/acute-care/