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Definition Return to top
A stroke secondary to carotid dissection is a loss of brain function due to a stroke caused by a tear in the lining of the carotid artery (a major artery in the neck which supplies blood to the front of the brain).Causes, incidence, and risk factors Return to top
Stroke is caused by a loss of blood circulation to an area or areas of the brain. The specific neurologic deficits may vary depending on the location, extent of the damage, and cause of the disorder. A carotid dissection is when a carotid artery develops a tear in its lining. The flow of blood in between the various layers of the blood vessel causes the layers to separate, resulting in the lumen (channel) narrowing.
Stroke secondary to carotid dissection, unlike many other forms of stroke, may occur in young people, usually under 40 years old. Dissection accounts for less than 5% of strokes.
The risks for stroke secondary to carotid dissection include a history of disorders that cause weakness of the blood vessels, such as Marfan's syndrome, fibromuscular dysplasia, and others. Risks also include injury or trauma of the neck. Invasive procedures that involve the carotid artery (e.g., arteriogram) can also put someone at risk.
Symptoms Return to top
Signs and tests Return to top
Findings may include any number of deficits. These can include abnormal vision, movement, sensation, reflexes, and speaking. Occasionally, these findings fluctuate with time, depending on how much blood flow is impaired at the moment they are measured.
An examination should include testing of all neurological functions, including visual, motor, sensory, and cognitive abilities, to determine the specific deficits present. The examination may show changes in vision or visual fields, changes in reflexes including abnormal reflexes or abnormal extent of "normal" reflexes, abnormal eye movements, muscle weakness, decreased sensation, and other changes.
A bruit, an abnormal sound heard with the stethoscope, may be heard over the carotid arteries of the neck. The blood pressure may be high. Horner's syndrome may occur, which involves a small pupil, drooping of one eyelid, lack of sweating on one side of the forehead, and a sunken appearance to one eye.
Tests (see also tests for stroke):
Treatment Return to top
For a full discussion of treatment, see Stroke.Expectations (prognosis) Return to top
The outcome for stroke secondary to carotid dissection may be better than for stroke from many other causes, especially if the dissection is discovered and treated promptly.Complications Return to top
See Stroke.Calling your health care provider Return to top
Stroke due to any cause is a medical emergency and requires immediate treatment. Go to the emergency room or call the local emergency number (such as 911) if symptoms occur.Prevention Return to top
Stroke secondary to carotid dissection may not be preventable in some instances. Care should be taken to protect the neck from injury, especially if diseases associated with an increased risk of this disorder are present. Safety measures, such as wearing seatbelts in a vehicle and helmets for various activities, may reduce the risk somewhat. Update Date: 7/13/2004 Updated by: Joseph V. Campellone, M.D., Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |