Carotid artery dissection: Difference between revisions

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Carotid Artery Dissection

Carotid artery dissection is a condition where there is a tear in the carotid artery wall. This can lead to a separation of the layers of the artery wall, creating a false lumen. This condition can result in stroke or transient ischemic attack (TIA) due to reduced blood flow or embolism.

Anatomy

The carotid arteries are major blood vessels in the neck that supply blood to the brain, neck, and face. There are two carotid arteries: the left and the right. Each carotid artery divides into the internal and external carotid arteries. The internal carotid artery supplies blood to the brain, while the external carotid artery supplies blood to the face and neck.

Pathophysiology

In carotid artery dissection, a tear in the intima, the innermost layer of the artery, allows blood to enter the wall of the artery and split its layers. This can lead to the formation of a hematoma within the artery wall, which can narrow the artery and reduce blood flow. Additionally, the dissection can create a flap that can lead to embolization of clots to the brain, causing a stroke.

Causes

Carotid artery dissection can occur spontaneously or as a result of trauma. Spontaneous dissections may be associated with underlying connective tissue disorders such as Ehlers-Danlos syndrome or Marfan syndrome. Traumatic dissections can occur due to neck injuries, such as those sustained in car accidents or sports.

Symptoms

Symptoms of carotid artery dissection can vary but often include:

Sudden onset of headache, often described as severe or "thunderclap"
Neck pain
Partial Horner's syndrome (ptosis, miosis, anhidrosis)
Amaurosis fugax (temporary vision loss)
Ischemic stroke symptoms, such as weakness or numbness on one side of the body, difficulty speaking, or facial droop

Diagnosis

Diagnosis of carotid artery dissection is typically made using imaging studies. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) are commonly used to visualize the dissection and assess blood flow. Computed tomography angiography (CTA) is another imaging modality that can be used.

Treatment

Treatment of carotid artery dissection aims to prevent stroke and manage symptoms. Options include:

Anticoagulation or antiplatelet therapy to prevent clot formation
Surgical intervention or endovascular therapy in severe cases

Prognosis

The prognosis for carotid artery dissection varies. Many patients recover fully with appropriate treatment, but some may experience recurrent strokes or persistent neurological deficits.

Related pages

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-'''Carotid Artery Dissection''' is a significant medical condition characterized by the formation of a tear in the [[carotid artery]], one of the major arteries that supply blood to the brain. This tear allows blood to enter the arterial wall and split its layers, leading to a reduction or even a complete halt in blood flow to the brain, potentially causing a [[stroke]] or transient ischemic attacks ([[TIA]]). Carotid artery dissection can occur spontaneously or as a result of trauma. It is a critical condition that requires immediate medical attention to prevent severe outcomes, including death.
+== Carotid Artery Dissection ==
-==Causes==
+[[File:Gray513.png|thumb|right|Diagram of the carotid arteries]]
-Carotid artery dissection may be categorized into two types based on its origin: spontaneous and traumatic. Spontaneous carotid artery dissection ([[SCAD]]) does not have a clear cause but is often associated with underlying connective tissue disorders such as [[Marfan Syndrome]] or [[Ehlers-Danlos Syndrome]]. Traumatic carotid artery dissection is usually the result of direct physical trauma to the neck, which can occur during car accidents, sports injuries, or even after chiropractic manipulations.
-==Symptoms==
+'''Carotid artery dissection''' is a condition where there is a tear in the [[carotid artery]] wall. This can lead to a separation of the layers of the artery wall, creating a false lumen. This condition can result in [[stroke]] or [[transient ischemic attack]] (TIA) due to reduced blood flow or embolism.
-The symptoms of carotid artery dissection can vary widely but often include:
-* Sudden onset of a severe headache or neck pain
-* [[Horner's syndrome]] (ptosis, miosis, anhidrosis)
-* Pulsatile tinnitus
-* Transient ischemic attack ([[TIA]]) or stroke symptoms, such as difficulty speaking, weakness on one side of the body, and vision problems
-==Diagnosis==
+== Anatomy ==
-Diagnosis of carotid artery dissection involves a combination of clinical assessment and imaging studies. The following imaging techniques are commonly used:
-* [[Magnetic Resonance Imaging]] ([[MRI]]) and [[Magnetic Resonance Angiography]] ([[MRA]]) of the neck, which can show the presence of a dissection and its effects on blood flow
-* [[Computed Tomography Angiography]] ([[CTA]]), which provides a detailed view of the arteries and can identify the location and extent of the dissection
-* [[Duplex ultrasonography]], which uses sound waves to visualize the blood flow and structure of the carotid arteries
-==Treatment==
+The [[carotid arteries]] are major blood vessels in the neck that supply blood to the brain, neck, and face. There are two carotid arteries: the left and the right. Each carotid artery divides into the internal and external carotid arteries. The internal carotid artery supplies blood to the brain, while the external carotid artery supplies blood to the face and neck.
-The primary goals of treating carotid artery dissection are to restore normal blood flow to the brain and prevent a stroke. Treatment options include:
-* [[Anticoagulant]] therapy, such as heparin and warfarin, to prevent blood clots
-* [[Antiplatelet]] therapy, such as aspirin, to reduce the risk of stroke
-* In severe cases, surgical intervention may be necessary to repair the dissection. Surgical options include [[endarterectomy]] or stenting to stabilize the artery and restore blood flow.
-==Prognosis==
+== Pathophysiology ==
-The prognosis for individuals with carotid artery dissection varies depending on the extent of the dissection, the speed of diagnosis, and the effectiveness of treatment. Many patients recover completely with appropriate treatment, but there is a risk of recurrence or permanent neurological damage.
-==Prevention==
+In carotid artery dissection, a tear in the intima, the innermost layer of the artery, allows blood to enter the wall of the artery and split its layers. This can lead to the formation of a [[hematoma]] within the artery wall, which can narrow the artery and reduce blood flow. Additionally, the dissection can create a flap that can lead to embolization of clots to the brain, causing a stroke.
-Preventing carotid artery dissection involves managing risk factors and avoiding activities that could lead to neck trauma. Individuals with connective tissue disorders or a family history of carotid artery dissection should be monitored regularly for signs of vascular problems.
+== Causes ==
+Carotid artery dissection can occur spontaneously or as a result of trauma. Spontaneous dissections may be associated with underlying connective tissue disorders such as [[Ehlers-Danlos syndrome]] or [[Marfan syndrome]]. Traumatic dissections can occur due to neck injuries, such as those sustained in car accidents or sports.
+== Symptoms ==
+Symptoms of carotid artery dissection can vary but often include:
+* Sudden onset of headache, often described as severe or "thunderclap"
+* Neck pain
+* Partial [[Horner's syndrome]] (ptosis, miosis, anhidrosis)
+* [[Amaurosis fugax]] (temporary vision loss)
+* [[Ischemic stroke]] symptoms, such as weakness or numbness on one side of the body, difficulty speaking, or facial droop
+== Diagnosis ==
+Diagnosis of carotid artery dissection is typically made using imaging studies. [[Magnetic resonance imaging]] (MRI) and [[magnetic resonance angiography]] (MRA) are commonly used to visualize the dissection and assess blood flow. [[Computed tomography angiography]] (CTA) is another imaging modality that can be used.
+== Treatment ==
+Treatment of carotid artery dissection aims to prevent stroke and manage symptoms. Options include:
+* [[Anticoagulation]] or [[antiplatelet therapy]] to prevent clot formation
+* [[Surgical intervention]] or [[endovascular therapy]] in severe cases
+== Prognosis ==
+The prognosis for carotid artery dissection varies. Many patients recover fully with appropriate treatment, but some may experience recurrent strokes or persistent neurological deficits.
+== Related pages ==
+* [[Stroke]]
+* [[Horner's syndrome]]
+* [[Ehlers-Danlos syndrome]]
+* [[Marfan syndrome]]
 [[Category:Vascular diseases]]
-[[Category:Stroke]]
-[[Category:Medical emergencies]]
-{{medicine-stub}}