Stroke secondary to carotid dissection

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Carotid dissection

• 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

Review Date: 02/20/2007
Reviewed By: Updated by: A.D.A.M. Editorial Team: Greg Juhn, M.T.P.W., David R. Eltz, Kelli A. Stacy. Previously reviewed by Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network. (August 2006)