Medical knowledge, Patient Education
Carotid Artery Dissection
A carotid artery dissection is a tear in a carotid artery. The carotid arteries are blood vessels on each side of the neck. They carry blood from the heart to the brain and other parts of the head. When an artery tears, blood collects inside the layers of the artery wall. This can cause a blood clot.
This condition increases the risk of a stroke if it is not diagnosed and treated right away.
What are the causes?
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A neck injury due to sudden or excessive neck movement. This is called a traumatic dissection.
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Weak blood vessel walls. The walls may tear even when no injury occurs (spontaneous dissection).
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An angiogram procedure. This is a rare cause of carotid artery dissection.
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Chiropractic manipulation. A minimal form of blunt trauma.
In many cases, the cause of this condition is not known.
What increases the risk?
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High blood pressure (hypertension).
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Migraine disorder.
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Inherited diseases or connective tissue disorders that weaken the blood vessels.
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Fibromuscular dysplasia.
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Tobacco use.
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Recent infection.
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Higher levels of an amino acid called homocysteine.
What are the signs or symptoms?
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Headache.
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Dizziness.
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Vertigo. This is a feeling that you or things around you are moving when they are not.
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Double vision.
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Eye, face, or neck pain.
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Weakness on one side of the face or body.
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Drooping eyelid.
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Loss of taste.
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Ringing in the ear.
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Loss of feeling on one side of the body. You may not be able to feel pain, heat, or cold.
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Loss of balance and coordination.
How is this diagnosed?
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CT angiogram. 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 your blood vessels more clearly.
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MRI angiogram. This is used to check the health of the blood vessels.
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Cerebral angiogram. This test takes X-ray images of the blood vessels in the neck and brain. A dye is used to show the inside of the blood vessels.
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Doppler ultrasound. This test uses sound waves to create images of the carotid arteries. It shows how well blood flows through your arteries.
How is this treated?
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Blood thinners. This medicine helps to prevent blood clots. This may be given first through an IV, and then as pills for 6 months.
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Antiplatelet medicines. This medicine keeps the platelets from sticking together, which prevents blood clots from forming.
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Procedures to widen a narrow blood vessel (angioplasty) or to place a mesh tube (stent) inside the blood vessel to keep it open.
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Surgery to repair the area. This is rarely needed.
Follow these instructions at home:
Medicines
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Take over-the-counter and prescription medicines as told by your health care provider.
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If you are taking blood thinners:
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Talk with your health care provider before you take any medicines that contain aspirin or NSAIDs, such as ibuprofen. These medicines increase your risk for dangerous bleeding.
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Take your medicine exactly as told, at the same time every day.
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Avoid activities that could cause injury or bruising. Follow instructions about how to prevent falls.
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Wear a medical alert bracelet or carry a card that lists what medicines you take.
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Lifestyle
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Work with your health care provider to control your hypertension. You may need to:
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Exercise regularly. Check with your health care provider before starting any new type of exercise.
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Eat a heart-healthy diet of fruits, vegetables, whole grains, and lean meats. Limit unhealthy fats. Eat more healthy fats such as avocados, eggs, and oily fish.
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Reduce the amount of salt (sodium) that you eat to less than 1,500 mg a day.
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Reduce stress by participating in things that you enjoy and avoiding things that cause you stress.
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Avoid activities that put you at risk for neck injuries, such as contact sports.
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Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your health care provider.
General instructions
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Keep all follow-up visits. This is important.
Get help right away if:
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You have any symptoms of a stroke. “BE FAST” is an easy way to remember the main warning signs of a stroke:
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B – Balance. Signs are dizziness, sudden trouble walking, or loss of balance.
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E – Eyes. Signs are trouble seeing or a sudden change in vision.
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F – Face. Signs are sudden weakness or numbness of the face, or the face or eyelid drooping on one side.
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A – Arms. Signs are weakness or numbness in an arm. This happens suddenly and usually on one side of the body.
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S – Speech. Signs are sudden trouble speaking, slurred speech, or trouble understanding what people say.
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T – Time. Time to call emergency services. Write down what time symptoms started.
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You have other signs of a stroke, such as:
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A sudden, severe headache with no known cause.
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Nausea or vomiting.
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Seizure.
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You have other symptoms, such as:
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Difficulty breathing.
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Chest pain.
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Do not wait to see if the symptoms will go away.
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Do not drive yourself to the hospital.
Summary
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A carotid artery dissection is a tear in a carotid artery. This can cause a blood clot.
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Treatment for this condition depends on the cause of your carotid artery dissection and your overall health. The most important goal of treatment is to prevent a stroke.
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The condition may be treated with blood thinners, procedures to widen a narrow blood vessel, or surgery to repair the area.
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Avoid activities that put you at risk for neck injuries.
This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.
