How does carotid artery dissection cause a stroke?

According to PhD.MD. Phung Dinh Tho from the Stroke Center, Bach Mai Hospital, arterial dissection occurs when the structure of the vessel wall is damaged, allowing blood to enter the vessel wall and form a hematoma.

This injury can cause a stroke through two main mechanisms: Narrowing or occlusion of the arterial lumen: The hematoma within the vessel wall narrows the lumen, reducing blood flow to the brain. Formation of thrombi leading to cerebral artery occlusion: A thrombus formed at the injured arterial site can break off, travel with the bloodstream, and occlude an artery within the brain.

Cervical artery dissection, including carotid and vertebral artery dissection, is an important cause of stroke in young people, accounting for up to approximately 25% of ischemic stroke cases in individuals under 50 years of age.

The condition can occur spontaneously, but in some cases, it is related to trauma or mechanical impacts on the neck region. Therefore, when taking the medical history of young stroke patients, doctors pay special attention to situations occurring before the onset, such as neck trauma, excessive neck movement, or maintaining an abnormal neck posture for a prolonged period.

Signs not to be ignored

Carotid artery dissection can manifest with localized symptoms before or simultaneously with the onset of cerebral ischemia.

Signs to watch out for include: o Headache or neck pain: Usually newly onset and different from previous headaches. o Horner's syndrome: Mild ptosis and miosis on the side of the lesion. o Pulsatile tinnitus: The patient may perceive a pulsing or "whooshing" sound in the ear synchronized with the heartbeat. o Signs of a stroke: Facial drooping, weakness or numbness on one side of the body, slurred speech, visual disturbances, or sudden neurological symptoms.

Caution with abnormal impacts on the neck region

PhD.MD. Phung Dinh Tho recommends that when sleeping or traveling long distances, one should avoid maintaining the head and neck in an excessively flexed, rotated, or tilted posture for a prolonged period. At the same time, avoid forceful neck manipulation, snapping, or twisting movements.

Particularly, if a new or abnormal headache or neck pain appears, especially after trauma or impact to the neck region, accompanied by neurological symptoms such as facial drooping, slurred speech, limb weakness or numbness, visual disturbances, etc., the patient must immediately go to a medical facility capable of stroke emergency care for timely evaluation and treatment.

The case of the 40-year-old patient is a warning that stroke does not only occur in the elderly. In young people, abnormal impacts on the neck region can also be factors associated with dangerous cerebrovascular injuries.

Kim Long