Carotid artery dissection
| Carotid artery dissection | |
|---|---|
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| Classification and external resources | |
| ICD-10 | I72.0 |
| ICD-9-CM | 443.21 |
| DiseasesDB | 2145 |
| eMedicine | emerg/82 |
Carotid artery dissection is a separation of the layers of the artery wall supplying oxygen-bearing blood to the head and brain and is the most common cause of stroke in young adults. (In vascular medicine, dissection is a blister-like de-lamination between the outer and inner walls of a blood vessel, generally originating with a partial leak in the inner lining.)
The signs and symptoms of carotid artery dissection may be divided into ischemic and non-ischemic categories:
Non-ischemic signs and symptoms
Ischemic signs and symptoms
The causes of internal carotid artery dissection can be broadly categorised into two classes: spontaneous or traumatic.
Once considered uncommon, spontaneous carotid artery dissection is an increasingly recognised cause of stroke that preferentially affects the middle-aged.
The incidence of spontaneous carotid artery dissection is low, and incidence rates for internal carotid artery dissection have been reported to be 2.6 to 2.9 per 100,000.
Observational studies and case reports published since the early 1980s show that patients with spontaneous internal carotid artery dissection may also have a history of stroke in their family and/or hereditary connective tissue disorders, such as Marfan syndrome, Ehlers-Danlos syndrome, autosomal dominant polycystic kidney disease, pseudoxanthoma elasticum, fibromuscular dysplasia, and osteogenesis imperfecta type I.IgG4-related disease involving the carotid artery has also been observed as a cause.
However, although an association with connective tissue disorders does exist, most people with spontaneous arterial dissections do not have associated connective tissue disorders. Also, the reports on the prevalence of hereditary connective tissue diseases in people with spontaneous dissections are highly variable, ranging from 0% to 0.6% in one study to 5% to 18% in another study.
Internal carotid artery dissection can also be associated with an elongated styloid process (known as Eagle syndrome when the elongated styloid process causes symptoms).
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