CV

Carotid Artery Dissection

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Carotid Artery Dissection

  • See Also
  1. Cervical Artery Dissection
  2. Traumatic Carotid Dissection
  3. Vertebral Artery Dissection
  4. Vertebral Artery Injury in Blunt Neck Trauma
  • Pathophysiology
  1. Most common Cervical Artery Dissection is of the Carotid Artery at 2-3 cm above Carotid Artery bifurcation
  2. Extracranial Internal Carotid Artery crosses over anterior Cervical Spine at C2-C3, at 2-3 cm above bifurcation
  • Causes
  1. See Cervical Artery Dissection
  • Findings
  1. Initial
    1. Ipsilateral Neck Pain
      1. Often present at onset
    2. Headache (most common)
      1. Sudden onset, unilateral, constant, throbbing Headache
      2. Thunderclap Headache may be present
    3. Horner Syndrome
      1. Typically partial Horner Syndrome (Miosis and Ptosis without Anhidrosis)
  2. Next
    1. Anterior cerebral ischemia
    2. Retinal ischemia
  3. Associated findings
    1. Carotid Bruit
    2. Focal neurologic deficits
      1. Often insidious or subtle developing over days to weeks
  • Complications
  1. Anterior circulation Cerebrovascular Accident
  2. Expanding Hematoma
  3. Arterial Hemorrhage
  4. Aneurysm formation
    1. Local mass effect (esp. compression of CN 9, CN 10 and CN 12)
    2. Subarachnoid Hemorrhage
  • Imaging
  1. See Cervical Artery Dissection
  • Management
  1. See Cervical Artery Dissection
  • References
  1. Hussein and Leiman (2022) Crit Dec Emerg Med 36(8): 4-8
  2. Blum (2015) Arch Neurosci 2(4) +PMID:26478890 [PubMed]