Brain Attack - Stroke from Carotid Dissection

What are the treatments for the condition?

A person with a stroke from carotid dissection is usually treated immediately with the blood thinner heparin administered through the vein. After heparin, another blood-thinning medication, warfarin, is taken orally.

If someone has the early warning signs of stroke, the emergency medical system should be contacted immediately. These signs include a sudden onset of:

Supportive therapy may also be needed with some strokes. This may include an artificial breathing machine, or ventilator, and an artificial feeding tube if the person cannot swallow.

Rehabilitation services can help to improve a person's function after a stroke. Physical therapy and other therapy, such as speech therapy or occupational therapy, may be used to maximize recovery.

What are the side effects of the treatments?

Excessive bleeding from the blood-thinning medications, or anticoagulants, is possible. People need to avoid activity that may cause bruises or cuts, such as rough sports or working with sharp tools.

What happens after treatment for the condition?

After the person is stable, treatment of the risk factors for stroke, as well as the cause of the stroke, is important to prevent further strokes. For instance, stopping smoking and controlling high blood pressure, diabetes, and high cholesterol are advised for most people.

Blood thinners such as warfarin may be discontinued in several months or a year depending upon the results of a repeat imaging test. The healthcare provider may discontinue these medications if the angiogram shows that the opening of the carotid artery is unblocked so that enough blood can flow through the artery. This is known as a patent artery and is considered to be at least 50% of normal diameter with a smooth wall.

Many people need assistance of one form or another after a stroke. This may range from using a walking cane to needing 24-hour-a-day skilled nursing care. Ongoing therapy to improve function is usually advised for at least 6 months if the person is able.

How is the condition monitored?

If an individual takes blood thinners, blood tests are normally done to assure the correct dose. These tests let a healthcare provider know if the person's blood is too "thin" or too "thick," which may require a dosage adjustment. Any new or worsening symptoms should be reported to the healthcare provider.