If we suddenly experience severe pain in our neck or head, or if a young person experiences symptoms similar to a stroke, we get a little worried, don't we? Sometimes a serious cause behind these things is a condition called a ruptured artery in the neck. Let's talk about this in detail and simply today.
What is Cervical Artery Dissection?
Simply put, a cervical artery dissection is a tear or rupture in one or more layers of the wall of the blood vessels, or arteries, in our neck. It's like a small burst in a water pipe.
Did you know, there are two very important types of arteries in our necks.
1. Carotid arteries: These are the arteries that supply blood to the front of our brain.
2. Vertebral arteries: These supply blood to the back of the brain and our spinal cord.
So, if there is a tear in one of these arteries, that is what we call `Cervical Artery Dissection`. The most serious thing here is that this can be a major cause of stroke, especially in young and middle-aged people .
How does this situation affect your health?
Imagine, when that artery wall breaks, some blood starts to leak through that break between the layers of the wall. This can cause a blood clot to form there. The most dangerous thing is, if this blood clot breaks free and blocks a small blood vessel in the brain, it can cut off blood flow to part of the brain and cause a stroke, especially an ischemic stroke.
Simply put, when an artery ruptures, a blood clot forms, and if it travels to the brain, it can cause a stroke.
Why is this happening? What are the reasons?
There is no single reason for this. Several factors may be involved.
1. Trauma to the head or neck
Often the main cause of this is an accident or injury to the head or neck. For example:
- Neck injuries (such as whiplash) from a car accident.
- Getting hit hard in the neck while playing sports.
- A sudden fall.
2. It can also be caused by fatigue for some people (Non-traumatic causes)
Sometimes this can happen without any major danger.
- Overexertion when lifting something heavy. Imagine going to the gym and suddenly trying to lift a lot of weight.
- Due to the pressure on the arteries in the neck when coughing, sneezing, or vomiting loudly.
3. Connective tissue disorders
Connective tissue in our body is a type of tissue that helps hold things like bones, cartilage, skin, and blood vessels together. There are some genetic diseases that weaken this connective tissue. People with such diseases are also at higher risk of developing a `Cervical Artery Dissection`. Here are a few examples:
- Ehlers-Danlos syndrome
- Fibromuscular dysplasia
- Marfan syndrome
- Osteogenesis imperfecta
These diseases can also weaken the walls of blood vessels, making them more susceptible to rupture.
4. Specific Neck Trauma
These are a little different from normal injuries.
- Neck Sprains and Strains: As mentioned earlier, whiplash conditions occur in automobile accidents.
- Holding your neck in the same position for a long time: For example, someone painting a ceiling with their head tilted up for a long time.
- Sudden, rapid neck movements: When riding things like roller coasters, or during some chiropractic neck manipulations (it is important to have these done by a qualified person).
- Lifting and carrying heavy objects: Especially when done incorrectly.
5. Recent illnesses
This condition can also occur when we are tired due to certain illnesses.
- Stomach upset with frequent vomiting: At this time, pressure is placed on the arteries in the neck.
- Respiratory infections such as fever and colds with persistent cough.
6. Other risk factors
Some other things increase the risk:
- Atherosclerosis: This is when fatty deposits build up inside the artery walls, narrowing the arteries.
- High blood pressure: This causes constant pressure on the arteries.
- Smoking: Smoking is very harmful to blood vessels.
What are the symptoms of this? How do you recognize it?
In many cases, it is not possible to definitively diagnose a cervical artery dissection until about a month after the onset of symptoms. However, there are several main types of symptoms.
1. Severe, sudden headache or neck pain
This is the most common symptom. This pain is not like a normal headache.
- It starts suddenly.
- It doesn't disappear, it continues to exist.
- The pain often occurs on one side of the head (especially behind one eye) or on one side of the neck .
- It may feel like a cluster headache , a migraine , or a thunderclap headache ( a thunderclap headache is a severe headache that comes on suddenly, like a bolt of lightning).
2. Horner's syndrome
This affects the spontaneous movements of our eyes and face. Symptoms include:
- Drooping eyelids.
- The pupil of one eye is smaller than the other eye.
- Decreased or absent sweating on one side of the face.
This `Horner's syndrome` usually affects only one side of the head.
3. Stroke-like symptoms
These symptoms occur when part of the brain is not getting enough blood. These are considered an emergency and medical advice should be sought immediately.
- Difficulty walking, staggering (ataxia).
- Loss of balance in the body (Balance problems).
- Blurred vision.
- Dizziness.
- Double vision (Diplopia).
- Numbness or weakness in an arm or leg.
- Speech difficulty / Dysarthria or Aphasia. (Slurred speech, inability to speak clearly)
- Feeling like things are spinning around you (Vertigo).
Who should be especially concerned about this?
Cervical Artery Dissection can be a bit tricky to diagnose. However, if you experience one or more of the symptoms listed above, especially if you experience sudden, severe neck/head pain along with symptoms of a stroke, you should definitely tell your doctor. Your doctor may suspect this and perform the necessary tests.
How do doctors diagnose this?
There are special tests to see exactly if this condition exists.
- CTA Scan (Computed Tomography Angiography - CTA): This can take detailed pictures of the blood vessels.
- MRA Scan (Magnetic Resonance Angiography - MRA): This is another advanced scan used to view blood vessels.
These scans can clearly see if there is a tear in the artery or if a blood clot has formed.
What are the treatments for this? (Treatment)
The good news is that most of these arterial tears heal on their own over time. However, treatment is essential to prevent serious conditions like stroke.
The main treatments are medications that reduce blood clotting:
- Antiplatelet therapy: This is done to prevent platelets in the blood from clumping together and forming blood clots. Examples of this include drugs like `Aspirin` and `Clopidogrel`.
- Anticoagulant medications: These are also called "blood thinners." They inhibit the process of blood clotting. Heparin is given as an injection, and Warfarin is given as a pill.
The doctor will determine which of these medications to give and for how long, based on your condition.
What if normal treatment is not successful?
Very rarely, if medication alone is not enough, surgery such as stenting may be necessary. A stent is a small mesh tube that is inserted into the artery, repairs the tear, strengthens the artery wall, and allows blood to flow better.
How to protect yourself from this situation? (Prevention)
If you have a medical condition (such as the connective tissue diseases mentioned above) that increases your risk of developing a `Cervical Artery Dissection`, it is very important to have regular checkups with a vascular specialist.
Everyone else can do these things to reduce this risk:
- Don't keep your neck in the same position for too long (e.g., like painting the ceiling).
- Avoid sudden, rapid neck and head movements (rollercoaster rides, certain neck manipulation techniques).
- Avoid lifting heavy weights with excessive exertion.
- Eat a heart-healthy diet (low in fat and oil, high in fruits and vegetables).
- Exercise regularly. (Ask your doctor what exercises are right for you.)
- Control your blood pressure. If necessary, take medication such as ACE inhibitors.
- Stop smoking completely.
What is the prognosis? (Prognosis)
Most cases of cervical artery dissection heal very well. The artery returns to normal. This healing process usually takes three to six months .
How is it to live with this situation?
If you have a cervical artery dissection, you will need to have regular checkups (such as scans) until your doctor is sure it has completely healed. You will also need to continue taking the antiplatelet or anticoagulant medications mentioned earlier during this time.
Although cervical artery dissection is a leading cause of stroke in people between the ages of 40 and 60, not everyone who has it will have a stroke. Most people recover without complications with proper testing and treatment. The main goal of treating those who have symptoms is to prevent a stroke.
Take-Home Message
Cervical Artery Dissection is a potentially serious condition, especially in young people, as it can lead to stroke.
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If you experience sudden, severe neck/head pain, pain behind the eyes, or symptoms of a stroke (difficulty speaking, numbness in the limbs, difficulty walking) , seek medical advice immediately.
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Several factors can contribute to this condition, including accidents, overexertion, and some genetic diseases.
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This condition can often be cured with proper treatment and medical supervision. The most important thing is to act quickly and not ignore the symptoms.
If you have any further questions about this, don't hesitate to talk to your doctor. Stay healthy!
` Cervical Artery Dissection, Stroke, Neck Pain, Headache, Blood Vessels, Blood Supply to the Brain
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