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Stroke

Spontaneous Carotid Artery Dissection

03/10/2011

Question:

My daughter just had this happen to her. She is feeling fine, but has to be on blood thinners for a while. Our question is this: How long does a dissection take to heal and will she have to be on blood thinners for a long time. She is 42 years old and is very healthy otherwise. Has always exercised and is at her perfect weight. She has done a couple of triathlons in the past 2 years and for now, she has had to stop exercising, ie: swimming, jogging, weight lifting, etc. When can she expect to resume her activities. She is the type of person that needs to see the healing process, but of course, if no other MRI/xrays are done on her carotid artery, she has no visual clue on how the healing is coming along. That happened to her 3 1/2 weeks ago. She is seeing a neurologist in her hometown, but is not sure if he is the right doctor to see, or if she should she a neurosurgeon. She is busy with work and kids, and she asked me to research this situation for her. And I am gladly doing it. Thanking you in advance for your response.

Answer:

It can be variable. If the dissection was intracranial, she should see a neurologist or neurosurgeon.

If it was in the neck, she should be seeing a vascular surgeon. There is no absolute time frame as to when to resume normal activities, so a conversation with her doctor should take place.

Also, understanding the underlying pathology if possible is important…trauma to the vessel, hypertension, fibromuscular dysplasia, connective tissue disorder, drugs, etc.

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Response by:

Jean  E Starr, MD Jean E Starr, MD
Clinical Associate Professor of Vascular Surgery
College of Medicine
The Ohio State University