Vertebral Artery Dissection

What is Vertebral Artery Dissection

Vertebral artery dissection is a tear in a vertebral artery. The vertebral arteries are major blood vessels at the base of the neck. They carry blood from the heart to the brain. When an artery tears, blood collects inside the layers of the artery wall. This can cause a blood clot.

This condition increases the risk for stroke if it is not diagnosed and treated right away. It is a common cause of stroke in people who are 30–45 years old.

What are the causes?

This condition may be caused by:

  • A neck injury due to sudden or excessive neck movement.
  • Having weak blood vessel walls. The walls may tear even when no injury occurs (spontaneous dissection).

What increases the risk?

The following factors may make you more likely to develop this condition:

  • High blood pressure (hypertension).
  • Migraines.
  • Inherited diseases that affect the strength or shape of the blood vessels.

What are the signs or symptoms?

Symptoms of this condition include:

  • Stabbing, sharp pain in the head, neck, eye, or face.
  • Vertigo. This is a feeling that you or your surroundings are moving when they are not.
  • Dizziness.
  • Double vision.
  • Difficulty speaking.
  • Loss of balance.
  • Difficulty swallowing.
  • Hoarse voice.
  • Loss of feeling in the torso, legs, or arms.
  • Loss of taste.
  • Hiccups.
  • Nausea and vomiting.
  • Hearing loss.
  • Ear pain.

Symptoms usually appear within days of an injury, but sometimes they may not appear for weeks or years.

How is this diagnosed?

This condition may be diagnosed based on tests, such as:

  • CT angiogram. X-ray images of your vertebral arteries are taken. A dye makes the images clear.
  • MRI angiogram. This is used to check the health of blood vessels.
  • Cerebral angiogram. X-ray images of blood vessels in the brain and neck are taken. A dye makes the images clear.
  • Doppler ultrasound. This test creates images using sound waves. It shows how well blood flows through your arteries.

How is this treated?

Treatment depends on the cause of your condition and your overall health. The goal of treatment is to prevent a stroke. If you are having a stroke, it is important to get treatment quickly. Treatment may include:

  • Blood thinners. This medicine helps to prevent blood clots. This may be given first through an IV, and then as pills for 3–6 months.
  • Procedures to widen a narrow blood vessel (angioplasty) or to place a mesh tube (stent) inside the blood vessel to keep it open.
  • Surgery to repair the area. This is rarely needed.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If you are taking blood thinners:
    • Talk with your health care provider before you take any medicines that contain aspirin or NSAIDs. These medicines increase your risk for dangerous bleeding.
    • Take your medicine exactly as told, at the same time every day.
    • Avoid activities that could cause injury or bruising.
    • Follow instructions about how to prevent falls.
    • Wear a medical alert bracelet or carry a card that lists what medicines you take.

Lifestyle

  • Work with your health care provider to control hypertension. This may include:
    • Exercising regularly. Check with your health care provider before starting a new type of exercise.
    • Eating a heart-healthy diet of fruits, vegetables, whole grains, and lean meats. Limit unhealthy fats and eat more healthy fats.
    • Reducing the amount of salt (sodium) that you eat to less than 1,500 mg a day.
    • Reducing stress by doing things that you enjoy and avoiding things that cause you stress.
  • Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.

General instructions

  • If you drink alcohol, limit how much you have:
    • 0–1 drink a day for women.
    • 0–2 drinks a day for men.
      • Be aware of how much alcohol is in your drink. In the U.S., one drink equals one typical bottle of beer (12 oz), one-half glass of wine (5 oz), or one shot of hard liquor (1½ oz).
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you:

  • Feel weak or dizzy.
  • Have a fever.

Get help right away if:

  • You have any symptoms of a stroke. “BE FAST” is an easy way to remember the main warning signs of a stroke:
    • B – Balance. Signs are dizziness, sudden trouble walking, or loss of balance.
    • E – Eyes. Signs are trouble seeing or a sudden change in vision.
    • F – Face. Signs are sudden weakness or numbness of the face, or the face or eyelid drooping on one side.
    • A – Arms. Signs are weakness or numbness in an arm. This happens suddenly and usually on one side of the body.
    • S – Speech. Signs are sudden trouble speaking, slurred speech, or trouble understanding what people say.
    • T – Time. Time to call emergency services. Write down what time symptoms started.
  • You have other signs of a stroke, such as:
    • A sudden, severe headache with no known cause.
    • Nausea or vomiting.
    • Seizure.
  • You have other symptoms, such as:
    • Difficulty breathing.
    • Chest pain.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

  • Vertebral artery dissection is a tear in an artery that carries blood from the heart to the brain.
  • This condition increases the risk for stroke if it is not diagnosed and treated right away.
  • You are more likely to develop this condition if you have hypertension, migraines, or certain inherited diseases that affect your blood vessels.
  • Treatment depends on the cause of your vertebral artery dissection and on your overall health. The most important goal of treatment is to prevent a stroke.
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