An Etiologic Model to Help Explain the Pathogenesis of Cervical Artery Dissection: Implications for Cervical Manipulation

Theoretical model on the etiology of CAD. Depicted are the 4 major categories of risk factors for CAD. Dissection is represented by the smallest gray shaded oval (areas 1 and 2) and should be viewed as a subset of those individuals with a genetic predisposition. Area 1 (light gray area) represents dissection occurring in a young individual (younger than 45 years) with a genetic predisposition triggered by environmental exposure(s) in the absence of significant atherosclerosis. Area 2 (darker gray area) represents dissection occurring in the presence of both environmental factors and trivial trauma.