ARTERIAL DISSECTION

Arterial Dissection Care

Specialized treatment for carotid and vertebral artery dissections — restoring vessel integrity.

Understanding

What Are Carotid and Vertebral Dissections?

A dissection occurs when a tear develops in the inner lining of an artery, allowing blood to enter the wall of the vessel. This creates a false channel that can narrow or block blood flow to the brain, or form a blood clot that travels upstream and causes a stroke.

Carotid and vertebral artery dissections can happen spontaneously or may be triggered by neck trauma, chiropractic manipulation, or even minor neck movements. They are a leading cause of stroke in younger adults, particularly those under 45.

Carotid and vertebral artery dissection
Symptoms

Signs & Symptoms

Dissections can produce a range of symptoms that may develop suddenly or gradually. Recognizing these signs is critical for prompt treatment.

Sudden neck pain or headache, especially on one side
Horner's syndrome — drooping eyelid, small pupil, and lack of sweating on one side of the face
Pain behind the eye or on one side of the face
Transient ischemic attack (TIA) symptoms — sudden weakness, numbness, or difficulty speaking that resolves
Pulsatile tinnitus — ringing in the ear that follows the heartbeat
Neck pain after trauma, sports injury, or chiropractic manipulation
Ischemic stroke symptoms — sudden weakness or numbness on one side, difficulty speaking, vision loss
Signs and symptoms of arterial dissection
Treatment

Treatment Options

MM
Medical Management

Many dissections can heal on their own with conservative management. Treatment typically involves anticoagulation or antiplatelet medication to prevent blood clots from forming at the site of the tear, combined with careful monitoring. Most patients improve with this approach over a period of weeks to months.

EV
Endovascular Repair

When a dissection causes significant narrowing, blood clot formation, or persistent symptoms despite medical therapy, endovascular repair may be needed. Using catheter-based techniques accessed through a small incision in the wrist or groin, our team can place stents to support the damaged artery wall and restore normal blood flow to the brain — all without open surgery.

Endovascular treatment options for dissection
Approaches

Understanding Your Treatment Path

The majority of carotid and vertebral artery dissections heal with medical management alone. Understanding what to expect can help ease concerns:

Medical Management (Most Common)
Blood thinners (anticoagulants or antiplatelets) are prescribed to prevent clots from forming at the tear site. Regular imaging follows the healing process. Most dissections heal within 3–6 months. This is the first-line treatment for the majority of patients.
Stenting (When Needed)
If the dissection causes significant narrowing that restricts blood flow, or if a blood clot forms despite medication, a stent may be placed via a catheter to hold the artery open. This is minimally invasive and performed under sedation — not general anesthesia.
Surgery (Rare)
Open surgery for dissection is rarely needed. It is reserved for cases where endovascular approaches have failed or the anatomy makes catheter-based treatment impossible.
Treatment approach for arterial dissection
Advanced

Endovascular Repair Options

Our team offers several catheter-based approaches, depending on the type and location of the dissection:

Stent Placement
A self-expanding mesh tube (stent) is positioned across the dissected segment to hold the artery open and restore normal blood flow. The stent acts as a scaffold for the artery wall to heal.
Stent-Assisted Coiling
For dissections that have formed a pseudoaneurysm (a bulging weak spot in the artery), coils are placed inside the aneurysm while a stent keeps the parent vessel open.
Flow-Diverting Stents
Advanced stents with tighter mesh patterns that redirect blood flow away from damaged areas while allowing the vessel to heal naturally over time.
Endovascular repair for arterial dissection
Frequently Asked Questions

Dissection questions, answered

Related Conditions

StrokeDissection is a stroke causeCerebral AngiographyDefinitive diagnosticCarotid DiseaseRelated carotid pathology

Experiencing neck pain or neurological symptoms?

Prompt evaluation of arterial dissections can prevent serious complications. Contact our neurovascular team today.

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