A carotid artery dissection is a medical condition where the walls of one of the carotid arteries in the neck begin to separate, creating a small pouch of tissue where blood accumulates. This condition can be extremely dangerous in some patients. Treatment options can include medications to prevent clotting, along with surgical repair of the vessel, depending on the exact location and the severity.
The condition starts with a small tear in the lining of the artery, allowing blood to start pooling between the lining and one of the outer layers. Over time, the size of the tear can increase. This may lead to an occlusion of the carotid artery or to the formation of a clot. The clot may loosen and travel to the brain, potentially causing a stroke. Carotid artery dissection is a relatively rare cause of stroke, but has been fingered as a potential culprit in people of all ages.
Causes of carotid artery dissections usually involve strain to the neck, as seen in whiplash injuries, energetic athletic injuries, and overextensions of the neck. Patients may notice pain in the neck, a ringing in the ears, and numbness. If the condition causes a stroke, slurred speech, lack of muscle control, and confusion may occur.
A medical imaging study called an angiogram, where tracer dye is injected and followed on a screen, is used to diagnose carotid artery dissection. The dye will pool around the site of the dissection and the supply of blood will appear decreased above the location. For small tears, measures like blood thinners to prevent clotting may be sufficient. Other patients may need an angioplasty surgery, where the blood vessel is repaired and reinforced to allow blood to move freely past the carotid artery dissection.
These arteries are very important and potential blockages are a cause for considerable concern. People on blood thinners or other treatments for a carotid artery dissection should make sure all care providers are aware and should also receive regular follow-up treatment to evaluate the tear and see if it is spreading or changing in nature. Interventions like surgery may be required later if the patient's condition changes.
Similar dissections can happen in other vessels of the body. In major vessels like the aorta, they can be extremely serious and may constitute a medical emergency. There can be a potential risk of rupture, in which case the patient may bleed to death in a matter of minutes.