| Carotid artery dissection | |
|---|---|
| Other names | Internal carotid artery dissection |
 | |
| Ateries of the neck | |
| Specialty | Vascular surgery |
| Symptoms | Pain in the neck or head, stroke symptoms[1] |
| Complications | Stroke, subarachnoid bleed[1] |
| Usual onset | 20s to 40s[2] |
| Causes | Neck injury, spontaneous[1] |
| Risk factors | Family history[1] |
| Diagnostic method | Medical imaging[1] |
| Differential diagnosis | Cluster headache, migraine, neck injury, TIA, vertebral artery dissection, retinal artery occlusion[1] |
| Treatment | Anticoagulation, stenting[1][2] |
| Prognosis | Variable[1] |
| Frequency | 1.8 per 100,000 per year[3] |
Carotid artery dissection is a flap-like tear of the inner lining of the carotid artery, which is located in the front of the neck and supplies blood to the brain.[1] Classically symptoms include pain in the neck, face, or head on one side.[1] This may be accompanied stroke symptoms such as blindness in one eye, abnormal taste, or double vision.[1][3] Other symptoms may include Horner's syndrome (small pupil with a droopy eyelid).[3] Complications may include stroke or subarachnoid bleed.[1]
It may occur after injury to the neck, such as a traffic collision or chiropractic manipulation; but may also happen spontaneously.[1] Risk factors for spontaneous dissection include a family history and connective tissue disorders such as Ehlers-Danlos Syndrome.[1] After the tear, blood enters the arterial wall and forms a blood clot, thickening the artery wall and often impeding blood flow.[1] Diagnosis is by medical imaging, usually a CT scan.[1]
Treatment may include aspirin, heparin, or warfarin.[1][2] Stenting of the blood vessel may occasionally be done.[1] Outcomes are variable.[1] Outcomes are worse if the dissection extends to inside the skull or occurs on both sides.[4]
Carotid dissection is rare, affecting about 1.8 per 100,000 people per year.[1][3] They most commonly occur in peoples 20s to 40s.[2] It is the reason for about 20% of strokes in young people.[1] It is more common than vertebral artery dissection (dissection of the smaller arteries in the back of the neck).[3] The condition was first described in 1954 by Jentzer.[4]
References edit
- ^ a b c d e f g h i j k l m n o p q r s t u Goodfriend, SD; Tadi, P; Koury, R (January 2020). "Carotid Artery Dissection". PMID 28613585.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b c d Ferri, Fred F. (2020). Ferri's Clinical Advisor 2020 E-Book: 5 Books in 1. Elsevier Health Sciences. p. PA315-IA7. ISBN 978-0-323-67977-0.
- ^ a b c d e Kim YK, Schulman S (April 2009). "Cervical artery dissection: pathology, epidemiology and management". Thromb. Res. 123 (6): 810–21. doi:10.1016/j.thromres.2009.01.013. PMID 19269682.
- ^ a b Purdy, R. Allan; Rapoport, Alan M.; Sheftell, Fred D. (2005). Advanced Therapy of Headache. PMPH-USA. p. 226. ISBN 978-1-55009-252-3.