Dissection of Carotid Artery

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Dissection of Carotid Artery

Background

Carotid Artery Dissection (CAD) happens when there is a tear to one of the carotid arteries, and blood under arterial pressure is able to rush through the arterial wall and split the media or subadventitial layers of the artery wall. This blood in the walls of the artery can also cause narrowing or complete occlusion of the vessel. This dissection can lead to cause of an aneursymal dilatation or intramural hematoma. Dissection of a carotid artery can either be intracranially or extracranially

Carotid Artery Dissection can occur in many different ways: it can be spontaneous, hereditary, caused from underlying arteriopahy, blunt injury, or trauma. This dissection can most commonly lead to an ischemic stroke that can happen in patients of all ages, and is the most common cause of strokes in patients younger then the age of 50.

Symptoms

There are a variety of symptoms associated with a carotid artery dissection. The most common symptom is a headace that is described as being constant and severe.

Other symptoms include: neck and facial pain

orbital pain

transient episodic blindness

neck swelling

focal weakness

decreased taste sensation

Treatment options

The best form of treatment is to catch the dissection process as early as possible so that treatment can be easier/cheaper. If the patient first presents to the hospital with common dissection symptoms, a CT of the head should be performed, along with either a CTA of MRA to correctly diagnose the problem and find the dissection. Early onset dissection treatments could include observation, anticoagulants such as IV heparin, antithrombic therapy, or antiplatelet therapy. Further treatment options could include an angioplasty, stent placement, or carotid artery ligation.

(The above images show the location of a carotid artery as well as the difference between a normal artery and a dissected artery.)



References

Carotid Artery Dissection. (2010). Wikipedia.com. Retrieved April 14, 2010 from http://en.wikipedia.org/wiki/Carotid_artery_dissection

Dissection, Carotid Artery. (2009). Emedicine from web md. Medscape. Retrieved April 14, 2010 from http://emedicine.medscape.com/article/757906-overview

Google Image. (2010) Retrieved April 14, 2010 from ohiohealth.com

Google Image. (2010) Retrieved April 14, 2010 from nlm.nih.gov