Cervical artery dissection can be divided into vertebral artery dissection and carotid artery dissection. Vertebral and carotid arteries are two pair of large arteries on each side of your neck that carries blood to your brain. The condition may occur when there is a tear in the walls of any of these arteries.
Noticeably, it is not the tear itself that is dangerous, but the clot forming to “heal” the tear and stop bleeding. If blood clot takes shape, the arterial wall can be thickened, and blood flow may be impeded.
Stroke is a typical symptom of cervical artery dissection. It is one of the most common causes of stroke in people under the age of 50, accounting for 10–25% of ischemic strokes in young and middle-aged people.
Generally speaking, there are two
categories of causes for cervical artery dissection:
- Traumatic cervical artery dissection
This type of cervical artery dissection
happens because the vertebral or carotid arteries were injured once. Commonly, patients
admitted to the hospital after a major motor vehicle accident can be diagnosed
with cervical artery dissection.
- Spontaneous cervical artery dissections
This means that the arteries in the neck have no injury or trauma before and the condition develops spontaneously. This form of cervical artery dissection may be triggered by certain medical conditions, such as Marfan or vascular Ehlers-Danlos syndromes, fibromuscular dysplasia or atherosclerosis.
Risk factors for cervical artery dissection
- Age under 50
- High blood pressure
- Invasive diagnostic procedures
- Family history
Sometimes, a stroke is the first sign of cervical artery dissection and requires emergency treatment. The stroke can develop hours, days or even a week after other symptoms begin. These signs and symptoms of the disease include:
- Severe headache
- Neck and face pain
- Vision disturbances
- Pulsatile tinnitus
- Swollen neck
- Migraine symptoms
- Drooping eyelid
- Difficulty speaking or swallowing
- A sudden decline in sense of taste
- Weakness in one side of the body
If a blood clot forms in the arterial walls
and a stroke occurs because a cervical artery dissection, you may experience
the classic symptoms of a stroke. These can include:
- Pain and numbness on one side of your face
- Numbness or changes in sensation on one side of your body
- A feeling of spinning or moving when your body is actually still
To diagnose cervical artery dissection,
your doctor will first talk to you about your medical or family history and
symptoms. Then, the doctor may arrange some imaging tests to look at the neck
and brain. They are effective in confirming the diagnosis immediately. These
- Cerebral angiography
This is the conventional type of angiography. It uses a contrast dye and X-ray to image the blood vessels. It may not be as accurate as non-invasive imaging technologies.
- Computed tomography angiography (CTA)
CTA can be the gold standard for use in
patients with symptoms of cervical artery dissection. This is a noninvasive
type of imaging that uses CT technology and a contrast dye to provide an
accurate, three-dimensional picture of the arteries on a computer screen.
- Magnetic resonance angiography (MRA)
MRA uses a magnetic field and radio waves
to provide pictures of the carotid and vertebral arteries. It can be performed
without or with a special type of contrast material.
- Doppler ultrasound
This technology can detect abnormal blood
flow in a dissected carotid artery. It has the advantages of being fast,
noninvasive and easy to use at the patient’s bedside.
Treatment for cervical artery dissection may vary depending on its cause, location, and severity. Usually, the plans of treatment aim to prevent complications of the disorder, such as a stroke.
Medications that can help control or prevent blood clots involve:
- Thrombolytics to break up blood clot
- Antiplatelet medicines, such as aspirin or clopidogrel
- Anticoagulants, such as heparin and warfarin
In most cases, medical treatments can work well, so surgery is only considered in very exceptional circumstances. If you cannot take anticoagulant or antiplatelet medicines or medicines doesn’t work for you, your doctor may suggest some procedures to help prevent blood clots forming. These surgeries include:
An angioplasty is done by putting a balloon
into a narrow or blocked artery to widen it.
A stent is a mesh tube inserted into the artery so that blood can still flow through it easily once the balloon has been removed.
Keyword: cervical artery dissection.