Understanding Carotid and Vertebral Dissections
What are Carotid and Vertebral Dissections?
Carotid and vertebral artery dissections are injuries that occur in the major arteries supplying blood to the brain. They can result from trauma, genetic conditions, or spontaneously, leading to the tearing or separation of the artery's layers, creating a false lumen where blood can accumulate and form a clot, obstructing blood flow or causing a stroke.
What to Watch For
Patients may experience sudden, severe headaches, neck pain, pulsatile tinnitus, visual disturbances, or stroke-like symptoms such as weakness, facial droop, difficulty speaking, and loss of coordination.
While dissections oftentimes heal on their own, certain associated findings can complicate or prevent healing and potentially require repair.
- Dissection Flaps: A tear in the artery wall that can act as a flap, allowing blood to enter the vessel wall and potentially obstruct blood flow.
- Pseudoaneurysms: Occur when blood escapes through the tear and pools between the artery's layers, forming a bulge that mimics an aneurysm.
- Stenoses: Narrowing of the arteries caused by the dissection, which can reduce blood flow to the brain, leading to ischemic symptoms.
Treatment Options
Our treatment goal is to restore normal blood flow and prevent stroke. Depending on the dissection's location, severity, and symptoms, treatment options include:
- Medical Management: Initial treatment often involves antiplatelet or anticoagulant medications to prevent clot formation and stroke.
- Endovascular Treatment: For cases where medical management is insufficient or the risk of stroke is high, we may recommend endovascular procedures such as stenting to stabilize the dissection flap, close off pseudoaneurysms, or widen narrowed sections of the artery.
