Ignoring 'this symptom' could lead to a stroke! Warning signals from carotid artery dissection.
Stroke, a medical emergency in which brain function is damaged due to blockage or rupture of a cerebral blood vessel, is generally known as a disease that occurs in older adults.
However, there have been cases of stroke in younger people who do not have typical risk factors such as high blood pressure, hyperlipidemia, or diabetes. In these cases, carotid artery dissection is considered one of the main causes.
Many people today experience forward head posture syndrome due to prolonged use of computers or smartphones. When the neck, which supports the head, is subjected to continuous strain, the neck muscles-especially the sternocleidomastoid muscle-are prone to stiffness.
To relieve this, some people excessively bend their necks or repeatedly apply strong pressure through massage. However, this can directly compress the carotid artery running below the neck, potentially causing serious vascular damage.
Beneath the sternocleidomastoid muscle lies the carotid artery, a major vessel supplying blood to the brain. Excessive pressure or bending of this area can temporarily reduce or block blood flow to the brain, resulting in symptoms such as dizziness, blurred vision, or fainting.
In more severe cases, carotid artery dissection may occur. The carotid artery wall consists of three layers: the intima, media, and adventitia. If strong external force or pressure tears the layers, blood can enter between them, leading to narrowing or blockage of the vessel.
If a dissection occurs between the intima and media, blood seeps into the tear, causing the intima to bulge inward and narrow the vessel lumen, or in severe cases, completely block it. In addition, a blood clot may form at the torn site, and if this clot breaks off and travels to the brain, it can block a cerebral vessel and cause an ischemic stroke.
In the early stages of carotid artery dissection, neurological symptoms may not appear. It often begins with neck pain, headache, or facial pain. The pain may radiate behind the eye, below the ear, or under the jaw, and unlike other muscle aches or common headaches, it is usually limited to one side and lasts for a long time.
As the dissection progresses, reduced blood flow to the brain may cause symptoms such as speech difficulties, visual disturbances, and numbness in the arms or legs, sometimes accompanied by fainting or severe dizziness. In addition, if nerves around the carotid artery are compressed, symptoms such as drooping of one eyelid or pupil constriction may occur.
Diagnosis is made using MRI (magnetic resonance imaging), MRA (magnetic resonance angiography), or CTA (computed tomography angiography) to assess changes in blood flow within the carotid artery, the location of the dissection, and the degree of vascular narrowing. If necessary, cerebral angiography may be performed for a definitive diagnosis and treatment planning. Treatment options include medication, endovascular procedures, or surgical intervention, depending on symptoms and the extent of vascular damage.
Choi Jaehyuk, Director of the Cerebrovascular Center at Daedong Hospital and a neurosurgeon, stated, "Carotid artery dissection can occur not only due to genetic connective tissue disorders or trauma, but also from minor stimuli in daily life, so caution is needed. Avoid not only neck massage but also activities that excessively bend or compress the neck, such as yoga, judo, wrestling, or golf swings. If you experience sudden head or neck pain or neurological symptoms, it is important to see a neurosurgeon immediately."
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