Carotid Artery Dissection

The carotid arteries are important blood vessels. They are found on each side of your neck. They carry blood from your heart to your brain and other parts of your head. The carotid arteries are made up of 3 layers of tissue. If an artery tears, blood can collect between these layers. This is called a carotid artery dissection. The blood that collects between the layers may form a clot. The clot then blocks blood from flowing to your brain. This can cause a stroke. A stroke can also occur if a piece of the clot breaks free and travels to the brain. Sometimes a stroke happens right away. Other times, it develops hours or days after the dissection. Most people recover from a carotid artery dissection. However, damage from a stroke may take a long time to go away. Some damage may be permanent.

CAUSES

  • Neck injury due to a car crash, sports injury, or similar event. This is called a traumatic dissection.

  • Weak blood vessel walls. The walls may tear even when no outside injury occurs. This is called a spontaneous dissection.

RISK FACTORS

Factors that may make a spontaneous carotid artery dissection more likely to occur include:

  • High blood pressure.

  • Buildup of fatty substances (plaque) on the artery walls. This is called hardening of the arteries (atherosclerosis).

  • Inherited diseases such as Marfan syndrome that weaken the blood vessels.

  • Fibromuscular dysplasia. This condition is caused by abnormal growth of cells inside the blood vessels.

  • Taking birth control pills.

  • Smoking.

SYMPTOMS

Symptoms of carotid artery dissection are similar to signs of a stroke. They include:

  • Headache.

  • Face or neck pain.

  • Changes in vision.

  • Weakness on one side of the face or body.

  • Drooping eyelid.

  • Loss of taste.

  • Ringing in the ear.

Any of these symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in U.S.). Do not drive yourself to the hospital.

DIAGNOSIS

To determine whether you have a carotid artery dissection, your caregiver will probably order imaging tests. These tests may include:

  • Helical computed tomography angiography. This test uses a computer to take X-rays of your carotid arteries. A dye may be injected into your blood to show the inside of the blood vessels more clearly.

  • Magnetic resonance angiography. This test uses a computer and radio waves to make images. A dye may also be used.

  • Doppler ultrasonography. This test uses sound waves to show the carotid arteries. The test will also show how well blood is flowing through your arteries.

TREATMENT

The type of treatment you get will depend on what caused your carotid artery dissection and your overall health. The most important goal of treatment is to prevent a stroke. If you had a stroke, it is important to get treatment quickly. Treatment options may include:

  • Blood thinners. This medicine helps to prevent blood clots.

  • You may get blood thinners through an intravenous line (IV) in the hospital.

  • Once you are home, you will probably take blood thinners in pill form. You may need to take these pills for 3 to 6 months.

  • Angioplasty. This is a procedure that widens a narrow blood vessel.

  • Stent placement. This is a procedure that places a mesh tube inside the blood vessel to keep it open.

  • Surgery to repair the area. This may be needed if you cannot take blood thinners or if blood thinners do not work for you.

HOME CARE INSTRUCTIONS

  • Only take over-the-counter or prescription medicines as directed by your caregiver. Follow the directions carefully.

  • Eat a heart-healthy diet. If you need help with this, meet with a dietician for advice.

  • Maintain a healthy weight. Ask your caregiver what weight is best for you.

  • Get regular exercise. Check with your caregiver before starting any new type of exercise.

  • Do not smoke.

  • Keep all follow-up appointments as directed by your caregiver. This is how your caregiver can make sure your treatment is working.

SEEK MEDICAL CARE IF:

  • You have any questions about your medicines.

  • Your symptoms are not getting better.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have any new symptoms.

  • Your symptoms get worse.

  • You feel numb, weak, or dizzy.

  • You notice changes in your vision or speech.

  • You have trouble breathing.

  • You have chest pain.

  • You have a fever.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.