A stroke secondary to carotid dissection is a type of stroke due to a tear in the lining of a major neck artery, called the carotid artery.

A stroke is an interruption of the blood supply to any part of the brain. When a tear in the lining of the carotid artery occurs (carotid dissection), blood flows in between layers of the blood vessel. This causes narrowing of the vessel, which makes it hard for blood to travel properly.

Stroke secondary to carotid dissection, unlike many other forms of stroke, may occur in young people, usually under 40 years old. Dissection accounts for less than 5% of strokes.

The risks for stroke secondary to carotid dissection include a history of disorders that cause weakness of the blood vessels, such as Marfan syndrome and fibromuscular dysplasia. Injury to the neck and certain medical procedures involving the carotid artery (such as an arteriogram) also raises your risk.

• Pain in the neck, which may travel to the eye
• Pulsing in the ears (pulsatile tinnitus)
• Weakness or total inability to move a body part
• Numbness, loss of sensation, or tingling
• Horner's syndrome
  • Eyelid drooping (ptosis)
  • Abnormal pupils
  • Abnormal facial sweating
• Trouble seeing, may occur in one or both eyes
• Problems talking or understanding speech
• Inability to recognize or identify sensory stimuli (agnosia)
• Loss of memory
• Vertigo (abnormal sensation of movement)
• Loss of coordination
• Swallowing difficulties
• Personality changes
• Mood and emotion changes
• Change in consciousness such as sleepiness, stupor, or lethargy
• Loss of consciousness
• Coma

A complete physical and neurological exam should be performed. This includes testing of all neurological functions, including vision, ability to feel sensations, movement, and mental function. The exam may reveal problems with vision, movement, sensation, reflexes, and speaking. The signs depend on how much blood flow is blocked at the time of the exam.

The doctor may hear an abnormal sound called a bruit when placing a stethoscope over the neck arteries. Blood pressure may be high. Some patients should signs of Horner's syndrome, such as drooping of one eyelid, lack of sweating on one side of the forehead, and a sunken appearance to one eye.

Tests may include:

• MRI or CT of the head
• Cerebral angiography
• MRA or a vascular ultrasound
• Blood tests to check for problems with connective tissue or certain genes