Definition
There are a range of potential vascular pathologies of the neck which have the potential to mimic musculoskeletal problems (vascular masqueraders).
Typical signs and symptoms
Typically in addition to neck pain clinical features such as headache, facial pain, cranial nerve deficits, TIA/ wider neurological symptoms will form part of the clinical picture.
Prevalence and risk factors
Vascular pathologies of the neck are rare, but are an important consideration in patients presenting with neck and head pain.
Occurrences of vascular pathologies of the neck are complex and multifactorial. Rarely is an event associated with a single causal factor.
It is important to note that there is a different risk profile for dissection and non-dissection events.
- Dissection events most commonly present with a history of trauma, with cardiovascular factors being less common
- Non-dissection events most commonly occur in the presence of cardiovascular factors
An absence of risk factors does not necessarily rule out the risk of serious neuro-vascular event.
Guidance
The International Federation of Musculoskeletal Physical Therapists have produced an international framework and resource to help improve clinician awareness of the range of potential vascular pathologies which may masquerade as MSK pain and dysfunction- see here IFOMPT cervical framework final 2020.pdf
Relevant Resources
Headaches: Headache – RefHelp Page (includes guide to differentiating primary headache disorders, headache as a new complaint including adult assessment
Facial pain: Facial Pain-Neurology – RefHelp Page
Transient ischaemic attack (TIA) and stroke: Transient Ischaemic Attack (TIA) And Stroke – RefHelp Page
Vertigo and dizziness: Vertigo and dizziness – RefHelp Page
M.A & P.A – 14-05-26
