What is carotid dissection?

A tear in one of your carotid arteries is medically termed as carotid dissection. On both sides of your neck sit these two arteries that supply the blood to your brain.

A tear of the inner layer of an artery's wall is called a dissection. Blood can enter through the tear and split the layers of the wall. The wall of the artery becomes swollen. Blood flow through the artery may be slowed or stopped by the bulge. The bulge may potentially cause problems by applying pressure to adjacent tissue or nerves.

Your body's clotting system may be activated by the tear. Then a clot can obstruct blood flow at the tear site. Or the clot can shatter into pieces. These may cause blocked blood flow in the smaller branches of the artery. This may lead to a stroke or TIA.

Any age can cause a carotid dissection. Younger individuals are more prone to have it than older people. For individuals under fifty, it is one of the common causes of stroke. Men are slightly more likely to have it than women.

What signs of carotid dissection are present?

Some people do not have any symptoms. In other cases, symptoms can begin all of a sudden or come on slowly over several days. They might include:

• Headache
• Pain in the scalp
• Discomfort in one eye
• Pain in the neck
• One eye (partial Horner syndrome) with a small pupil and drooping eyelid
• One half of your body weak or numb
• Having difficulty speaking or understanding speech
• Pulsing in the ear that ends
• Difficulty swallowing
• Abnormal or reduced sense of taste

Who is at risk for carotid dissection?

A few things can increase your risk. But some patients with dissection have none of those risk factors.

Some genes may increase your risk in certain circumstances. You may be at greater risk if you have a family member who has had an arterial dissection. Other factors that may increase your risk include:

• Infection
• High blood pressure
• Headaches due to migraines
• Taking oral contraceptives and smoking
• Alcohol abuse
• Low cholesterol levels

You are also at risk if you have any of the following medical conditions:

• Little portion of bone near the jaw, a long styloid process (Eagle syndrome, rare)
• Dysplastic fibromuscular disease
• The Ehlers-Danlos syndrome
• The Marfan syndrome
• The homocystinuria
• Deficiency in alpha-1 antitrypsin
• Imperfect Osteogenesis
• Aortic cystic medial necrosis
• Mediolytic arteriopathy in segments
• Lack of reticular fibre
• Syndrome of Reversible Cerebral Vasoconstriction
• Autosomal Dominant Polycystic Cause of Kidney Disease

What causes of carotid dissection?

Commonly, an injury to the neck is often the cause for this disease. The cause can be from car collision. Or from any kind of injury, which results in more than normal head extension or turning.

Certain medical conditions may weaken the walls of arteries. They are thus more susceptible to dissection.  Most of these dissections occur simultaneously. The patient often does not remember any neck injuries in these cases.

Certain physical activities may lead to a dissection, including:

• Scuba diving or swimming
• Skating
• Dancing
• Participating in sports such as volleyball, basketball, or tennis
• Practicing yoga
• Riding such as roller coasters
• Taking a trampoline jump
• Giving birth
• Engaging in sexual activity
• Sneezing or coughing
• Receiving a chiropractic adjustment to your neck (rare)

It can also occur spontaneously or for no identifiable reason.

How is the carotid dissection diagnosed?

The diagnosis of a carotid dissection begins with asking the patient for history and symptoms. The physician could also ask them about any new activities and injury. Your physician will conduct face, eyes, muscle strength, and reflexes while doing the examination for physical strength, as well as your sensory perception.

You might have testing to rule out stroke, brain haemorrhage, nerve problems, and headache kinds. Additionally, you might have carotid artery imaging testing. The purpose of these is to examine blood flow. You might have the following tests:

• MRI of the neck and brain
• Brain and neck magnetic resonance angiography (MRA)
• CT scan of the skull
• Computed tomography angiography of the skull (CTA)
• Ultrasonography with Carotid Doppler

You may need further testing if you have a medical condition that predisposes you to a dissection. You may need to see a neurosurgeon, vascular surgeon, or neurologist. One of these doctors can diagnose and treat your dissection.

What is the treatment for carotid dissection?

You will probably need to visit the hospital to check on your health and receive first treatment. The course of treatment will depend on your age, general health, and symptoms. They may include:

• Thrombolytic medication if you have a stroke
• Use of heparin to prevent blood clots
• IV fluids
• Blood pressure medications
• Glucose or insulin to regulate blood sugar
• Pain medications such as naproxen, ibuprofen, or acetaminophen
• Antiplatelet drugs such as aspirin
• Anticoagulant drugs such as warfarin

You may be on antiplatelet or anticoagulant drugs for three to six months. Then, you may require imaging tests to monitor the healing of your artery.

If your symptoms of carotid dissection persist, your doctor can offer one of the following:

• Insertion of a stent or tube into the artery
• Surgery to repair or avoid the artery

What potential side effects could carotid dissection cause?

Blood flow to the brain or eyes may become impaired after a carotid dissection. This can cause one-sided blindness, a stroke, or TIA. These are all emergent medical situations.

When do I need to call my doctor?

If your symptoms worsen or if you develop new ones, let your doctor know.

Why Tender Palm Super-Speciality Hospital for carotid dissection?

Tender Palm Hospital, owned by doctors, is renowned for attracting the most experienced professional in the country, with the finest neurologist and neurosurgeons specialized in carotid dissection. Tender Palm stands out as the premier Neurology hospital in Lucknow, India. Boasting cutting-edge infrastructure and advanced technology, Tender Palm ensures top-notch medical care for its patients.

To seek an expert consultation for any Neurology condition

Call us at +91-9076972161
Email at care@tenderpalm.com

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