CADISS (Cervical Artery Dissection in Stroke Study) was an open-label trial that randomized 250 patients with extracranial dissection within 7 days from symptom onset to receive either antiplatelets or anticoagulants in the following 3 months.593 The specific agents and treatment regimens were left to the treating physician. Stroke or death occurred in 3 patients (2%) assigned to antiplatelets versus 1 patient (1%) in the anticoagulation group (OR, At the 1-year follow-up, there was no difference in the primary end point of stroke or death between the 2 groups: 3.2% in the antiplatelet group versus 1.6% in the anticoagulant group (OR, 0.56 [95% This trial supports that there is equipoise between antiplatelets and anti- coagulants in the first 3 months after a cervical artery dissection. 3. Endovascular procedures are used to reconstruct cervical arterial dissections refractory to medical treatment and to treat complications such as pseu- There is a lack of randomized studies to support benefit of endovascular inter- ventions in dissections, and most of the data stem from small series. Still, reviews of the literature suggest a reasonably low rate of complications from these procedures.595,596 Knowledge Gaps and Future Research Gaps in the management of cervical arterial dissection still exist and would benefit from future research: Early identification of patients at risk for early dete- rioration or complications who might benefit from endovascular therapy. Whether some antithrombotic agents are more effi- cacious if administered early in the course (eg, is anticoagulation more efficacious than antiplatelets in the acute phase?). The benefit of long-term antithrombotic agents. Management of dissections complicated with intra- luminal thrombus. Management of intracranial dissections and risks/ benefits of anticoagulation. The determination of what physical activities are safe and which ones need to be restricted. Optimal monitoring/management of pseudoan- eurysms associated with dissection needs further study. 5.8. 