Pathophysiology

Cervical arterial dysfunction is presented as a broad clinical concept that goes beyond the older focus on vertebrobasilar insufficiency and manipulation risk. The lecture clarifies key acronyms, especially the different meanings of CAD, and explains why clinicians need to distinguish between cervical arterial dysfunction, cervical artery dissection, and carotid artery dissection when reading research and assessing patients. The main emphasis is on understanding vascular pathology in the head and neck as an umbrella that includes dissection, inflammation, compression, stretching, narrowing, occlusion, vasospasm, atherosclerosis, aneurysm, thrombus formation, and embolization. Learners are shown that blood vessels themselves can be a source of pain, and that risk assessment should focus less on whether a technique is “safe” and more on whether the patient may already have an underlying vascular disorder. The lecture also outlines how patient profiling and subjective history guide suspicion, including cardiovascular comorbidities, headache and neck pain patterns, and warning signs such as Horner’s syndrome or later ischemic features. It finishes by introducing diagnostic pathways such as ultrasound and angiographic imaging, leading into a later section on practical assessment.