Initial Symptoms
The initial symptom is usually pain. Most commonly, headache which occurs in about 70% of patients.
In vertebral artery dissection, the pain is often occipital, extending into the neck.
In carotid artery dissection, the pain can be headache, neck or facial pain. The pain is ipsilateral to the dissection.
Focal neurological signs then follow in about 60% of patients. These often develop several days after the onset of pain and display different patterns depending on the vessel involved.