Cervical artery dissection is dissection of one of the layers that compose the carotid and vertebral artery in the neck (cervix). They include:
Carotid artery dissection, a separation of the layers of the artery wall supplying oxygen-bearing blood to the head and brain. Vertebral artery dissection, a flap-like tear of the inner lining of the vertebral artery that supply blood to the brain and spinal cord.Cervical dissections can be broadly classified as either "spontaneous" or traumatic. Cervical artery dissections are a significant cause of strokes in young adults.A dissection typically results in a tear in one of the layers of the arterial wall. The result of this tear is often an intramural hematoma and/or aneurysmal dilation in the arteries leading to the intracranial area.Signs and symptoms of a cervical artery dissection are often non-specific and can be localized or generalized. There is no specific treatment, although most patients are either given an anti-platelet or anti-coagulation agent to prevent or treat strokes. Epidemiology
Cervical artery dissection has been noted to be a common cause of young adult strokes, with some sources indicating a prevalence of up to 20% in this young adult population with annual incidence rates between 2.6 and 2.9 per 100,000, although these incidences may be misleading with true incidences being higher because clinical presentations can vary, many being minor or self-limited, and thus these dissections can go undiagnosed.
Vandetanib, sold under the brand name Caprelsa, is an anti-cancer medication that is used for the treatment of certain tumours of the thyroid gland. It acts as a kinase inhibitor of a number of cell receptors, mainly the vascular endothelial growth factor receptor (VEGFR), the epidermal growth factor receptor (EGFR), and the RET-tyrosine kinase. The drug was developed by AstraZeneca who later sold the rights to Sanofi in 2015. Medical use
Vandetanib is used to treat medullary thyroid cancer in adults who are ineligible for surgery. Contraindications
The V804M mutation in RET confers resistance to Vandetanib anti-RET activity.In people with moderate and severe hepatic impairment, no dosage for vandetanib has been recommended, as its safety and efficacy has not been established yet. Vandetanib is contraindicated in people with congenital long QT syndrome.