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Although uncommon, dissection of the extracranial carotid artery accounts for a sizable proportion of strokes in younger patients. Most of these patients are treated with either anticoagulants or aspirin; no randomized trials have verified which option is best.
In this observational study, Swiss neurologists reviewed data on 298 consecutive patients who presented to two university hospitals with carotid dissection between 1987 and 2005. Until 1997, the standard of care at these hospitals was heparin followed by warfarin; after publication of the International Stroke Trial (IST) in 1997 (JW Gen Med Jul 1 1997), many physicians began using aspirin therapy (even though the IST enrolled patients with ischemic strokes, not patients with dissectio…