What is carotid dissection?

A carotid dissection happens when there is a tear in one of the major arteries in your neck that carries blood to your brain. This tear allows blood to collect within the artery wall, which can narrow or block normal blood flow.

When blood flow is reduced or interrupted, it can lead to serious complications like a stroke. Carotid dissection is one of the more common causes of stroke in younger adults.

Carotid dissection can happen for different reasons. Sometimes it follows an injury, while other times it occurs without a clear cause.

Possible causes and risk factors include:

• Neck trauma, such as from a car accident or sudden movement
• Repetitive or intense physical activity
• High blood pressure
• Smoking
• Migraine headaches
• Genetic or connective tissue conditions
• Family history of artery problems

Symptoms

Symptoms can vary from mild discomfort to sudden, serious changes. In some cases, people may not notice symptoms right away.

Common symptoms include:

• Headache or neck pain
• Eye or facial pain
• Drooping eyelid or changes in pupil size
• Weakness or numbness on one side of the body
• A pulsing or “whooshing” sound in one ear
• Trouble swallowing
• Changes in taste

How is it diagnosed?

Your provider will begin by asking about your symptoms, medical history, and any recent injuries or activities. A physical and neurological exam helps check your strength, reflexes, and nerve function.

Imaging tests are essential to confirm the diagnosis. These may include:

• MRI or MRA to view blood vessels and brain tissue
• CT scan or CT angiography for detailed images of arteries
• Ultrasound to evaluate blood flow in the neck

These tests help identify the tear and rule out other possible causes of your symptoms.

How is it treated?

Treatment focuses on restoring healthy blood flow and preventing complications like stroke. Many people are monitored in the hospital at first.

Common treatments include:

• Medications to prevent blood clots, such as antiplatelets or anticoagulants
• Blood pressure control to reduce stress on the artery
• Pain relief as needed

If a stroke has occurred, clot-dissolving medications may be used in certain situations.

Most people continue medication for several months and return for follow-up imaging to track healing. In rare or severe cases, procedures such as stenting or surgery may be needed to repair the artery.

With timely care, many patients recover well, though close monitoring is important during the healing period.