Stroke secondary to carotid dissection
Key points
- 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).
- Stroke is caused by a loss of blood circulation to an area or areas of the brain.
- These can include abnormal vision, movement, sensation, reflexes, and speaking.
- 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.
Definition
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
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
- pain
o may occur prior to other neurologic deficits
o may be in neck
o may radiate into eye - pulsating noises may be present in the ear (pulsatile tinnitus)
- weakness or total inability to move a body part
- abnormal sensations
o numbness, loss of sensation
o tingling or other - Horner's syndrome
o eyelid drooping (ptosis)
o abnormal pupil
o abnormal facial sweating - decreased or lost vision, partial or temporary
- language difficulties (Aphasia)
- inability to recognize or identify sensory stimuli (agnosia)
- loss of memory
- vertigo (abnormal sensation of movement)
- loss of coordination
- swallowing difficulties
- personality changes
- mood and emotion changes
- consciousness changes
o sleepy
o stuporous, somnolent, lethargic
o comatose, unconscious
Signs and tests
Written and revised by
Gerald Hurowitz, M.D.
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