Stroke secondary to carotid dissection

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Carotid dissection

Stroke secondary to carotid dissection

Symptoms:

pain
- may occur prior to other neurologic deficits
- may be in neck
- may radiate into eye
pulsating noises may be present in the ear (pulsatile tinnitus)
weakness or total inability to move a body part
abnormal sensations
- numbness, loss of sensation
- tingling or other
Horner's syndrome
- eyelid drooping (ptosis)
- abnormal pupil
- abnormal facial sweating
decreased or lost vision, partial or temporary
language difficulties (aphasia)
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
consciousness changes
- sleepy
- stuporous, somnolent, lethargic
- comatose, unconscious

Signs and tests:

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Findings may include any number of deficits. These can include abnormal vision, movement, sensation, reflexes, and speaking. Occasionally, these findings fluctuate with time, depending on how much blood flow is impaired at the moment they are measured.

An examination should include testing of all neurological functions, including visual, motor, sensory, and cognitive abilities, to determine the specific deficits present. The examination may show changes in vision or visual fields, changes in reflexes including abnormal reflexes or abnormal extent of "normal" reflexes, abnormal eye movements, muscle weakness, decreased sensation, and other changes.

A bruit, an abnormal sound heard with the stethoscope, may be heard over the carotid arteries of the neck. The blood pressure may be high. Horner's syndrome may occur, which involves a small pupil, drooping of one eyelid, lack of sweating on one side of the forehead, and a sunken appearance to one eye.

Tests (see also tests for stroke):

MRI or CT of the head to determine extent and location of stroke
a cerebral angiography reveals changes indicating carotid dissection
MRA or a duplex/Doppler ultrasound can also detect dissection
Blood tests to determine if there are abnormalities in connective tissue or genetic causes of abnormal blood vessels