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A carotid dissection is a tear in one of your carotid arteries. These are a set of paired arteries at the sides of your neck. These arteries supply blood to your brain.
The first portion of each carotid artery is the called the common carotid artery. Each common carotid artery has an internal and an external branch. The external branch carries blood to your face and scalp. The internal branch carries blood to the front part of your brain.
A dissection is a tear of the inner layer of the wall of an artery. The tear lets blood get in between the layers of the wall and separate them. This causes the artery wall to bulge, and the bulge can slow or stop blood flow through the artery. It can also cause problems by pressing on nearby structures, such as nerves.
The tear can also trigger the body's clotting system. A clot can then block blood flow at the site of the tear. Or pieces of the clot can break off and block blood flow in smaller branches of the artery. Blocked or decreased blood flow can lead to a transient ischemic attack (TIA) or stroke.
A carotid dissection can occur at any age. It tends to occur more often in younger adults than in older adults. It is a common cause of stroke in people under age 50. It is slightly more common in men than in women.
An injury to the neck can cause carotid dissection. The injury may be caused by something like a car accident.
Some people with diseases that are known to weaken arterial walls are at greater risk for a dissection. These dissections can occur with vigorous physical activity such as:
A carotid dissection can also occur suddenly, without a known cause.
Researchers have found some factors that increase the risk of having a carotid dissection. But some people who get carotid dissections do not have any of those risk factors.
In some cases, genes may play a part. Having certain combinations of genes may increase your risk. If you have family members who have had artery dissections, you may have an increased risk. Other conditions that may increase your risk include:
Some people who have carotid dissection do not have any symptoms. In other cases, symptoms may occur suddenly or may develop over several days. Common symptoms include:
Your healthcare provider will ask about your symptoms and past medical conditions. He or she may also ask about recent injuries and activities. During a physical exam, your doctor may focus on your face and eyes, strength, reflexes, and sensation.
Tests are done to evaluate for different types of headaches, nerve disorders, bleeding of the brain, and stroke due to other causes. Imaging of the carotid arteries and evaluation of blood flow can help diagnose a dissection. Some tests that may be done include:
If you may have a specific condition that increases your risk of carotid dissection, you may need additional tests. Your doctor may refer you to a neurologist, vascular surgeon, or neurosurgeon to make the diagnosis and to manage your carotid dissection.
A carotid dissection can cause problems with blood flow to your brain or eyes. This can cause a TIA, stroke, or one-sided blindness. Any of these are medical emergencies. Call 911 if you think you might be having a stroke or TIA or if you have sudden loss of vision.
If your symptoms get worse or you have new symptoms, let your healthcare provider know.
Tips to help you get the most from a visit to your healthcare provider:
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