Learning About Head and Neck Artery Dissection

What is a head or neck artery dissection?

A head or neck artery dissection is a problem that happens when blood pools in the walls of blood vessels.

Head and neck arteries carry oxygen-rich blood through the neck and into the brain and face.

The walls of blood vessels are made up of layers. A tear in the wall allows blood to get between the layers and pool there. The blood forms a bulge that can press against a nerve in the neck or can restrict blood flow to the brain.

A blood clot can form that may block blood flow to the brain. Or a dissection may cause bleeding into the brain tissue. Either of these can cause a stroke.

What causes it?

The cause of a head or neck artery dissection is often unknown. It may be caused by some kind of movement or sudden change in the position of the head. This movement may be gentle or hard. For example, it could happen from trauma, such as a car crash, or from exercising.

Things that can increase the risk of an artery dissection include a chronic health problem that affects the blood vessel walls, a recent infection, and high blood pressure. Your risk can also increase if you've had an artery dissection in the past.

What are the symptoms?

The most common symptom is head, neck, or face pain. You may have a headache on one side of the head in the temple, eye, cheek, or teeth. It may be severe and sudden. Some people say it's like a "clap of thunder."

A dissection can cause stroke symptoms. These include:

• Sudden numbness, tingling, weakness, or loss of movement in the face, arm, or leg, especially on one side of the body.
• Sudden vision changes.
• Sudden trouble speaking.
• Sudden confusion or trouble understanding simple statements.
• Sudden problems with walking or balance.
• A sudden, severe headache that is different from past headaches.
• Fainting.
• A seizure.

An artery dissection may cause other symptoms. These include:

• Eye symptoms on one side of the face. You may have a drooping upper eyelid or one pupil that's smaller than the other.
• Weakness, numbness, or tingling on one side of the face.

It's important to call for medical help if you have stroke symptoms. Quick treatment may save your life. And it may reduce the damage in your brain so that you have fewer problems after the stroke.

How is it diagnosed?

Your doctor will ask about your symptoms and past health and do a physical exam. You will also have imaging tests of your head and neck. These may include:

• A CT scan.
• A CT angiogram (CTA).
• An MRI.
• A magnetic resonance angiogram (MRA).

How is it treated?

An artery dissection can heal on its own. But in some cases it can get worse, or other problems can happen. Your doctor may give you medicine to prevent blood clots. This may help prevent a stroke. You may need to take the medicine for a few months or longer. You may also have a procedure to remove a clot.

You can help keep your blood vessels healthy with a heart-healthy lifestyle. This lifestyle includes managing other health problems like diabetes, high blood pressure, and high cholesterol.

If the dissection causes a stroke, you will get treatment for the stroke and any problems that it causes. For example, you may have a procedure to remove a clot.