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Interior Carotid Artery Dissection--Who Knows Their Stuff?
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This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.

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Avatar_f_tn
That is wild,just pulling weeds.Glad you didn't have a stroke.  I had mine from a long dental appt. because my neck was hyper-extended for a few hours. Symptoms didn't start until a few days later though.  I am so careful now what I do.   Will be a long time before I go back to the dentist.  Crazy thing I am a hygienist...worked in the dental field for 25 years and never heard of such a thing.  At least I could clean my own teeth!!!
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Avatar_m_tn
I had a CAD in March 2012, full left side blockage but no stroke. I was on coumadine for 3 months, the follow up MR showed complete healing, my neurologist told me to stay on aspirin for another 6 months, he said I may drop it after that if otherwise not indicated. I still take it though, just in case. I do not think there are clear guidelines, or solid scientific data, but at least some physicians think it can be dropped. He said the chance of a recurring CAD is quite small.

I do not know anything about it in the context of delivery though, I would check it with a neurologist / OBGYN doctor.

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Avatar_f_tn
Can anyone advise? I have received an appointment for an MRI of the Auditory Canal (IAM) with and without contrast and also an MRI of the neck.  Would any of these show a dissection? I am so worried I'll have the scan and it will show nothing. Please see my previous posts about my symptoms.
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Avatar_n_tn
MRI w/ contrast is the best diagnostic tool for dissections. I would verify that the scan you are getting will also show any dissections of the carotid or vertebral arteries, not just in the neck, but in the head where they branch off. Also, could be something completely different since the pain has continued for months.
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Avatar_f_tn
thanks, I'm not too sure if they will concentrate on any area of my head since the pain is deep within the ear and neck and they are not bothered about the headaches and scalp pain, one GP laughed when I told him about the pain on my scalp feeling like spiders crawling across my scalp and feeling like someone has pulled patches of my hair out.  Yes I'm well aware it could be something totally different but after searching for months I can't relate my symptoms to anything or anyone apart from the people on here and what they have suffered, of course I haven't suffered any TIA's which many people do when they have had a dissection and I can't imagine what its like for those of you who have suffered one but hopefully I will eventually get a diagnosis on what it is and if anything it could help someone else so I'm hoping in the meantime to post on here(as long as people don't mind) until I have a diagnosis.  I've read all your stories on here and I believe people do suffer from head/neck pain for months afterwards.
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Avatar_m_tn
Hello!  I found this list after finally searching, thinking "I wonder if anyone else is as puzzled by this carotid artery dissection as I am, seems to be kinda rare" and voila!  Friends!
I am 3 weeks out of the hospital after 8 days in ICU and 3 more in observation.  Only two things I think I can add are that I had right carotid artery dissection, left vertebral artery dissection AND right vertebral artery dissection at the same time.  I went to the ER after stroke-like symptoms and a persistent ER doc insisted on MRI then CT with contrasy which showed the three dissections and got me admitted.  
I have 14 recorded "micro-strokes" and no long-term effects (well, 3 weeks out) but I was unable to stand or walk so the doctors placed two stents in the blocked carotid artery.
That artery had a large blood clot impeding blood flow and after 2 days of IV Heparin therapy but declining improvement, the doctors decided the clot wasn't going to clear with just Heparin. The titanium stent was intended to open the artery long-term but also squash the blood clot against the wall of the artery instead of waiting for it to break apart.
So far, so good.
I'm on Coumadin for 6 months and tapering off steroids (the word steroids makes me giggle) and taking lots and lots of blood pressure medication.  My blood pressure was high before.  Now it's so low it's a wonder I can stay awake all day.
What else ... I'm 44, mother of 8 children, I don't work away from home, and I'm not extremely athletic so no contact sports, trauma, anything to pinpoint how this happened except the day before I had the symptoms we were at the beach and my 6 year old son absolutely pummeled me in the waves ... but that's normal trauma for a mom, right?
It is absolutely amazing to me that some people can perform in Cirque du Soleil without injury and others of us can't have our hair shampooed at the salon without injury.  Amazing.
I was treated at the very excellent Army hospital in Honolulu where they did run every test imaginable and I came up normal or negative for every thing they could think of.  I'm hoping I don't have an underlying condition and can live without fear of this happening again.
Thank you for all of your comments and helpful attitudes toward each other.  I wish to help any way I can.
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Avatar_n_tn
On May 6, 2013 I was diagnosed with Right carotid artery dissection with formed pseudonymous  with neurological affects and now recovering from:
1. Right side of the tongue numbness/weakness-speech pat exercises-still difficult to eat and speak
2. Swallowing difficulties - self improving every day/adding speech pat exercises
3. Right vocal cord paralysis - speech pat exercises-no much improvement
4. Right shoulder/arm weakness -acupuncture helps-step by step improvement

I wonder if some one knows where else to read about my rare case on of which was described in 2007 in MedPub literature. I also interested if such cases connected with job environment as my impression that I got it because of work load and pressure. My position is Production shift supervisor in 24/7 facility with 25-35 people under me, 5 managers on the top.

Thank you in advance for any info about similar cases.
I located in Vancouver, BC, Canada
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Avatar_n_tn
From my experience if you have aneurism (aneurysm) or pseudo pseudo aneurism (aneurysm) which could have compressed nerves in the neck which signal to muscles to compress too - this is my case with shoulder/arm and partly neck  - so i was referred to acupuncture and IMS( inter muscular stimulation) what helping me now. O fcourse consult with you doc.
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Avatar_n_tn
My neurologist saying that MRI with contrast is where they could see even small dissections or aneurisms, etc.
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Avatar_f_tn
thanks, I had the scan and it showed nothing. The scan performed was of the Auditory Canal without contrast, apparently my symptoms does not warrant the use of contrast.  I'm glad to see this thread is still running and helping people.  I am however still suffering.  I still have a deep constant ache within my neck below my ear lobe.  I have a whirring noise within my head which has lessoned from a constant whooshing noise(like when having a baby ultrasound scan noise).  When the left side of my head is really sore the whirring is worse.  When I bend over to pick things up from the floor I get an almighty roar within my neck/ear & head, its very hard to describe but it feels like something is blocked.  I have visited 5 different GP's at my surgery and they have all said sometimes we can never get to the bottom of these things and can only treat the symptoms, so guess what they offered, yes they offered tramadol and anti-depressants.  I am now in the process of changing surgeries to find a new doctor who will help me discover what I am suffering from.
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Avatar_f_tn
Hi guys, i have a dissected right carotid artery and no strokes. It happened a couple of weeks ago. Im on Lovenox twice a day and have an appointment to see a neurologist the end of the month. Im 49, super healthy and not accustomed to medications so I'm wondering whether some of what I'm feeling might just be the drug. Does anyone else feel like gravity just doubles all of a sudden and you feel super heavy and slow? Then the aching headaches begin again. How long do the headaches stick around? The severity has decreased dramatically.
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Avatar_n_tn
I saw Rehab Doc who deal with after stroke patients and what he told me: new nerves grew 1 mm per month and this is very painful to tolerate but it is important part of the healing process as nerves trying to develop and find their way into body/muscles, so he told me be prepared for that. May be it is part of what you experiencing now, time frame from 3-24  months. Of course consult with your Rehab doc nor just neurologist.
Hope it helps.
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Avatar_f_tn
Hi,

I had an right internal carotid dissection about 1.5 months ago along with associated narrowing of the right vertebral artery.  I think it happened when I was lifting weights at the gym because I started getting the worst headaches of my life about half an hour after that.

I'm just trying to see what could have caused my arteries to be susceptible to tearing - all my inflammation tests are negative, I don't fit the bill for Ehlers-Danlos, etc.  The only thing I can think of is birth control pills - I started these about 7 months before the dissection (stopped it immediately afterwards).  Has anybody been on bc pills when they got their dissection?

Also, has anyone here taken Xarelto (Rivaroxaban) instead of warfarin?  My doctor switched me to this because my INR levels on warfarin were fluctuating too much.  If so, any feedback on this medicine would be greatly appreciated as it is relatively new and I cant seem to find too much out there.

Finally, does anybody know what the best centers/hospitals for treating ICA in the US are?
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Avatar_m_tn
i was hit by a car while riding a bicycle. I know the moment when my artery dissected. there as a hot poker feeling that went from my neck all the way to my left eye. That was 2004. Today, i wear a fentanyl patch and take oxycodone 4-5 times a day just to function. Sometimes the vision at the center of my left eye blurs, sound makes me jump and smells send a sharp pain through my left temple. There are days even with the opiates where i hide in my sensory deprivation room (laundry room, very very dark) for hours. I try every treatment that comes down the pike and as insurance companies will not pay for off label treatment the co$t$ are out of my pocket. Sorry i do not have uplifting news, but not everyone gets completely over a dissection..
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Avatar_f_tn
I am a vegetarian, active, non-smoking, normal wt  71 yo female.  No diabetes, bp is on the low side, etc.  Two weeks ago I was kayaking with a friend, lifting my 40 lb dog into the car, going to wt training 3 x week etc. etc The wt training had made me strong.  Maybe that was a mistake because I lifted alot of heavy stuff, hoisting stuff into my SUV.. I haven't eased gently into old age :)

Then I had a low grade headache that wouldn't go away and I thought it was sinus (allergies, whatever). One night it was so bad I couldn't sleep.  Next day, I felt good, headache gone. Went to change sheets on our bed.leaned over to lift up the mattress and fell over, paralyzed on left side.  called 911. Paralysis was gone when the EMT's came but they took me to the ER, anyway.  ER did a CT scan, saw "something" on the rt frontal lobe and admitted me. Daughter, a doc, thought that was amazing :since they rarely see anything on the CT like a stroke  -a CT  is not that sophisticated.  Next day they did every possible test and I was fortunate, in a way, with my age they took this "TIA" seriously. MRI, MRA, CT/angiogram, doppler, trans-esophageal something.

Bottom line : carotids were totally clear of plaque, heart was good.  They found a rt interior carotid dissection way up by the skull.  Occlusion around the dissection and a clot had formed in the part of the carotid that had "peeled away".  In hospital for 5 days. during which time I had the worst headache of my life one night . Everyone was great but discharge instructions were vague.

I have no paralysis or speech or mobility problems.  I'm very fortunate.

Went to PCP with doc daughter a few days after discharge.  PCP said he had rarely seen this condition and said there's not much literature on it.  Asked him about functional limitations.  He said: no driving for 3-6 weeks, no lifting, bending over (squat is OK), no straining for BM's,  and -yikes - no coughing or sneezing. I have to keep my head up and not turn it suddenly.  Can't do anything that would make a piece of the clot break off and go into my brain.  Basically said lots of limitations for 6 months at least.  I have cancelled travel with my husband (3 trips this fall) due to problems with lifting a suitcase, being jostled in a plane, jumping off a train to the platform in NYC, that kind of thing.  .

I can - and should walk only for exercise.Can't walk the dog because she might pull.

All this really *****, but to be honest all my functions are intact..  Good luck to everyone who has had this!   I never heard of this dissection problem before, my carotids are clear of plaque.
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Avatar_f_tn
Best of luck  to you.  Give yourself time.  You will be fine.  I had my right carotid artery with a stroke 17 months ago and I am doing just fine.  Symptoms have all gone away now.....but I am very careful not to lift anything heavy or do anything that will strain.  Mine happened from hyper-extending my neck so I am very careful about that.  You tend to learn what you can and cannot do.  I am feeling great now.  You are in my prayers.
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Avatar_f_tn
Thank you so much.  You know, they tell me not to  wonder about the cause of all this (but I do) and the day before this happened I had my hair done, leaning over the basin to get the color out. That is something I've done for years without a problem, but I do wonder.

Thank you for your reassurance about recovery and your prayers.
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Avatar_f_tn
This is some months after your post that I am replying and I hope you are doing well.  My symptoms only two plus weeks after my event are: waking up with a dull headache every night.  I get up and take a baby aspirin (I'm on Plavix) and sit up awhile until I feel better.  The headache might just be sinus, I don't know.  I don't have headaches during the day.  Sometimes I have a sore feeling running down my neck on the rt side.   Very tired, sleep alot.  Hope this helps.
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Avatar_f_tn
Read many places that hyper-extending your head at a beauty appointment can cause it.  Mine happened from a long dental appt.
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Avatar_m_tn
I am three weeks post CAD.  Still having a pounding headache for part of every day as well as shoulder pain on the affected side.  I have periods of slight dizziness and just feel crummy. Is this normal and how long will it last?
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Avatar_f_tn

I am almost three weeks post CAD now and get twinges of pain in my head during the day and headaches at night, waking me sometimes.  My tear and occlusion was way up in the artery, at the skull. They gave me trammadol to use for the pain but I prefer not to use it unless the pain is excruciating (which it hasn't been since I got home)  Still the headache pain is worrying, particularly since I had a headache all week and felt yucky, no energy before my CAD.  My daughter, a doc, said the headache was "vasospasm" and not to worry.  I guess this is all connected - headache, yucky feeling, no energy.   I'm not sure how normal this is but I hope this helps....
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Avatar_m_tn
Thanks for your reply.  It makes me feel like what I am going through is typical and not just something I am experiencing.  I am not taking anything for the headaches because they are tolerable.  I also feel a little off balance at times.  My pupils are still a different size and I hear the whooshing in my ear when I lay down to sleep.  Thanks for your reply it helps tremendously to know this is normal for now.....,
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Avatar_f_tn
Hello tarapatiki. I just wanted to reach out to you and give you a "Get well soon" I have not posted on this site for quite sometime Your dissection seems very similar to mine. My dissection was high up in my skull so a stent was not an option for me. My blood clot did dislodge from the torn artery and traveled to my frontal cerebral cortex of my brain. I did not any have underlying disease that could have caused this to happen. Like you I suffered a stroke but really have no after affects except my left hand I dont think will ever be the same. anyway it will be 2 years for me Jan 4. I know how hard this can be and its so sad how minimal info there is about this medical condition. You are in my prayers and I promise you it will get better. Hello to everyone else!
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Avatar_f_tn
Thanks so much for the words of encouragement.  I go to the vascular surgeon for a follow up and doppler on Tuesday  - it will almost be three months.  Hopeful they will see some changes.  My PCP says it takes 3-6 months to recover.  I'm still trying to figure out how this happened out of the blue to me.  I didn't have a sharp pain, just a gradual onset of symptoms, a worsening headache for a week or so. Here are some possible causes and I'm throwing them out so that others - physicians and pts - can possibly use the information. In the month or so before I had my CAD I did the following: Jumped on a trampoline with the grandkids and fell hard (don't laugh), carried my 41 lb dog to the car and hoisted her in because she hates cars, lugged  a very heavy large flower pot up a hill and then up stairs to our deck, pulled very heavy hoses around the yard, carried super sized bottled waters from the car to the house, lifted wts at the gym, hyper-extened my neck at the hairdresser and also by bending over using a sinus rinse.  I still have some headaches at night but never had to use the trammadol. Also some stabbing pains periodically on that right side of my head.  I'm still very tired.  I hope the info is helpful to everyone who goes through this awful experience.
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Avatar_m_tn
I just got the results of my latest doppler of my neck.  I had dissected Sept 18 so it is almost three months now. My dissection is resolving!.  I am so happy about that but still very tired.  My neurologist suggested a sleep study which showed I have severe sleep apnea.  No wonder I am always so tired.  I will probably need to use a CPAP at night.   I do not have headaches anymore and other than the fatigue feel quite well.  I still have absolutely no idea about how I dissected but I will just stay in the happy knowledge that I am healing.  Hope you get the same results.
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Avatar_f_tn
Oh, that is such good news. Such a relief. Congratulations!!!!! And guess what?  I just went yesterday to my vascular surgeon.  First, they did a doppler on both carotids.  I couldn't  hear the whoosh sound as loudly on the right as I could on the left.  And the tech was very supportive and sympathetic, wishing me good luck.  I thought, damn. Then I saw the doc who said my dissection appeared to be resolved.  I couldn't believe my ears.  He said no restrictions on activities except chiropractic or anything that would extend or snap my neck back. He said these dissections are  "random" and he had a curious lack of curiosity about the cause of my dissection (my daughter, a doc, says if you want curiosity about rare conditions, you go to an academic medical center). He told me (again) the story about the wife of a doctor in the next building to his (herself a doctor) who was helping the UPS man push his truck out of the snow and suffered a dissection from it.  But he said the good thing about dissections is that they will clear up by themselves, unlike plaque-clogged arteries that never clear up on their own and require surgery (endarterectomy)

I came home from the doctor's office and took a seven hour nap.  Relief, I guess.

Good luck with your CPAP.  It sounds like it severe sleep apnea might be the cause of your tiredness.  I had a sleep study in the middle of all this and they said only mild apnea.  

Very happy for you!!!  Report back on your tiredness and if the sleep study helps.  Thank you for your support. This is a very stressful condition. It feels like someone has a gun to your head and you never know when they are going to pull the trigger.
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Avatar_f_tn
I lifted weights (with a trainer) for several months before my dissection. In fact, the day before I had a mild transient stroke due to my rt carotid dissection,( even though I was feeling lousy and had a severe headache), I went to the gym (and also to the hairdresser).  However, I'm not sure this was the cause of my dissection.  It could have been a lot of other activities.  I never had the pain in my neck that signals a dissection.  Just headache and felt lousy/lethargic/out of it. Self-medicated with Excedrin which possibly prevented me from having a major stroke (all the aspirin in Excedrin).

They put me on Plavix in the hospital and even though my doc said my dissection has resolved he said I should continue on Plavix for a year since that was the "Standard of Care".  I'm taking a baby aspirin, too. Cvering all bases.  He said fine.    Don't know what factors enter into the decision to use coumadin or Plavix with each pt.  

Good luck finding a center for CAD.  There should be some good ones out there. Cleveland Clinic or Mayo?  I'm fairly satisfied with local treatment but if my CAD hadn't resolved, I'd search for second, or third opinions.
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Avatar_f_tn
I am new to this forum and grateful to have found this.  I am a female in my early 40s and recently learned I had a ICAD at C2 with a subsequent small aneurysm.  This after almost a year of an "inner ear infection" and a six week period of LE weakness on the opposite side of the dissection which was diagnosed as a running injury and physical therapy was sought for strength training.  I am on aspirin only.  My biggest complaint is a burning sensation on same side of head and neck as dissection.  I had dizziness and an imbalance that I just learned to live with.  That seems to be getting better.  My ear pain is improving and the pulsation in my ear is decreased.    I was restricted to indoor running but am able to workout (no yoga, no chiropractor, no ceiling painting, and still scared to lift weights).  

I realize how fortunate I am.  This experience taught me that we need to listen to our bodies.  My ENT doctor did everything right including ordering an MRI...the diagnosis simply got missed by the radiologist until further testing was done.

thanks to all of you that contribute to this blog.
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Avatar_m_tn
This forum is unbelievable!  I can't believe that I stumbled upon this accidentally when looking to see how long it takes to have a CAD heal.  Seems like there are a variety of times.  I tore my artery mountain biking in October.  I had an MRI a month and a half after the injury in December and they did find that it is starting to heal.  They have given me clearance to run and to not lift anything over 30lbs.  Is this the correct information?  When it first happened I was not sure what was going on.  I thought it was a reaction to medication I was taking.  I ended up going on a trip to Dubai for a week for work and couldn't figure out why I was so light headed and forgetful of words.  I came back and told my wife to take me to the ER.  They gave me an MRI and CT Scan and the results came back that I had a CAD, a pseudo aneurism (aneurysm) which caused a small stroke in my frontal lobe brain.  I was suffering tremendous headaches at the beginning.  They prescribed Vicodin and then switched to Flexeral which seemed to do the trick.  After two months the headaches have for the most part subsided.  I still get light headed from time to time when I over do things.  I have just learned to deal with that.  Also if I am too active my face will suffer from tingling in my face as well as pain in my neck on the side of the CAD.  I have been nervous to do anything active until this week.  I went jogging for two miles on Monday, rode a stationary bike on Tuesday for 20 mins, and did the elliptical for a half an hour yesterday.  I accompanied this by lifting 20 lb arm curls afterwords.  I was completely worn out afterwards and still suffering from the numbing sensation in my face and pain in my neck.  Is this something I should be worried about or should I just take it easy and not try to do so much?  I am worried that the Neurosurgeon does not know enough about my diagnosis.  Any thoughts out there? Thank you very much to whomever started this forum.  It has given me a tremendous amount of information about what happened.  More than the doctors so far!!!!
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Avatar_m_tn
Yes I have had the same symptoms.  Post injury I had headaches and dizziness.  After two months the headaches have vanished but I still get light headed as well as numbness and tingling in my left side of my face.  This is the same side as my torn CAD.  The artery has started to heal after the first scan and I return for a 4 month scan next month.  Not sure what will come of it.  I hope good news.  I find that if I overdue it, that I get the lightheadedness back as well as pain in my neck.  Do you have the same symptoms? I used to take Vicodin and now I just take 325 mg of aspirin a day.  If the headaches are really bad then I will take a single dose of Tylenol.  That is it though.  Anything else that works?
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Avatar_m_tn
I get stomach cramps to from time to time but I am not on any of the medication except for aspirin.  
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Avatar_m_tn
Hi...Glad to be amongst like-minded folk. Diagnosed with internal left carotid artery on 51st birthday following blindness in one eye a few minutes after go-karting. A clot had formed and blocked my retinal artery but excellent work from on-call orthopaedic NHS consultant resolved most of the vision issue..3 hours of intensive work at midnight and beyond. CAD diagnosed by MRI the following week following investigations into cause of clot. Completely occluded. Unlike some I spent no time in hospital and the diagnosis of stroke just floored me. Previously fit and well and non-drinker, non-smoker. Obviously restricted with driving and work but the brain needs recovery so trying to relax (its not easy though is it?). So encouraged to hear of many peoples stories and their three month scans (I have been promised similar) but having doppler scan in two weeks. I feel I am being well looked after and know I am already on the road to recovery....but sometimes I guess the road may not be the expected direct route, but its sometimes fun to explore. Good luck to all previous writers and I hope future ones find comfort in what they learn from an excellent forum.
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Avatar_f_tn
Well, I'm really no expert but here's how it has gone for me. I hope it's helpful.  I had my symptoms (transient left sided paralysis) on Sept 18th, 2013.  In the hospital, after my diagnosis, they told me to "take it easy" for 3-6 months and the vascular surgeon said they would do a doppler in his office.in about 3 months.  My PCP the next week told me not to drive for 3-6 weeks, not lift anything, not to bend over, avoid sneezing, coughing, straining, etc.  It was helpful to have these guidelines. He never mentioned lb limits to lifting  but I assumed nothing over 20 lbs.  My dog is strong and pulls on her leash so I hired a dog walker for her. I really tried to be very cautious.  I don't know what caused my CAD and it could be something random or trivial. I didn't drive until after I saw my vascular surgeon in mid-Dec. When I got that doppler my vascular surgeon said my artery was clear and I had"no restrictions".  But....I'm still very cautious. The clot apparently has dissolved and that's why my artery is no longer occluded but I think the artery wall must still be somewhat fragile. I had previously been doing strength training  and walked/ran on a treadmill, kayaked, lifted heavy stuff, etc.. Now I am only doing 20 minutes on a treadmill daily and plan to work up to more....very slowly. I've had lightheadness periodically that I think must be related to the CAD (I never had lightheadness before) and I've been really tired, although the tiredness has gotten better and is not as bad as it was in the beginning.  I have some problems retrieving words or names  - not too often but once in awhile.. .I think that might be related,  I recently have had some periodic pain in my neck (rt side) and mild headaches which I hope are sinus headaches   My sense is - as a layperson - that if symptoms recur after exercise, you are overdoing it.  Best to get back into an exercise routine  slowly.  again, that's me.  I don't think I will ever do yoga again (neck stretching), or kayak, or - most assuredly not jump on a trampoline. I'm on Plavix for a year.  Good luck!!!  It's a terribly scary thing. Makes you face mortality and requires modifications in thinking and behavior - at least until your body tells you that you are OK.
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Avatar_f_tn
Just re-read your post and it is filled with wisdom.  I hope you have continued to mend and feel swell.
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Avatar_m_tn
Need some help from all of you.  I'm a 38 year old male. Play ball or run three times a week.  For the last five weeks I have had a headache (which never climbs higher than a 6 if a 10 is a migraine, resonating from my left temple that spreads across my scalp, down to my jaw, behind my eyes, and behind my ear.  I feel like I am on a boat, have a hard time focusing of an evening, and am very fatigued.  My neck is stiff and the left side of my face (check and eye) tingle and feel swollen. It is tender to touch the left side of my face and head.  Five weeks ago the symptoms began about 2 in the afternoon and grew more frequent and started earlier.  Now they are constant but I feel my best in the early morning.  I have had an MRI and it stated that my brain was fine.  Has anyone else had these symptoms?   What are your suggestions for me?  Husband and father of two - scared.  
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Avatar_f_tn
You definitely need more medical testing.  An MRI by itself might show nothing.  What about a doppler to detect an obstruction in your carotid due to a clot forming after a tear?.  Headaches should not go on like that.  Your physical state has changed.  I felt strange/fuzzy for about a month before my symptoms got worse....headaches for a week and then a clot broke away from the occlusion and caused temporary paralysis in my left side.  Rt interior carotid was occluded 95 percent.  Don't let this continue without further testing and a dx.
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Avatar_f_tn
How are you feeling?  Have you had an MRA of your neck and brain?  These tests are different from M r I in that they focus on the blood vessels.
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Avatar_m_tn
I'm glad to have found this forum.  In November, I started having terrible headaches.  The kind that would wake me in the middle of the night with throbbing pain and nausea.  Several visits to the doctor resulted in misdiagnosis of sinus or migraine issues.  After having temporary loss of vision in one eye and 3 MRIs, they determined dissections.  

I was admitted to the hospital in December (it took several weeks to determine the cause of headaches) where I had an angiogram. Shockingly, I had 4 dissections! Both carotid and vertebral arteries leading to the brain were dissected.  Miraculously, I didn't suffer a stroke.  I don't have a trauma or event that can be linked to the dissection.  I was extremely fit, running most days and doing cross fit exercise.  

I've been on Plavix, aspirin, and blood pressure medicine to allow healing.  At the 3 month mark, I had another CTA. Dr feels I am about 90% healed but continued me on meds and exercise restrictions.  I am only allowed walking....no running, weights, lifting, etc.  At the 5-6 month mark, I will have another CTA and hope to come off the medicine.  I still have the weird twinges in the head, neck and ears.  The awful whooshing sound finally stopped at about 3 months out.  

I know it is very rare to have 4 dissections.  What tests should I ask for to determine an underlying issue? Has anyone heard of Cross fit causing dissections?  I've seen a few specialists but everyone is hesitant to do anything til I'm fully healed.  I don't seem to have any indicators for Marfans, etc. although FMD might be a possibility.  I'm thankful to God to be here and glad to be feeling mostly normal.  Thanks for any insight others can offer on underlying causes.
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Avatar_m_tn
Did you ever find out about supplements? Husband had carotid dissection - on warfarin and bp meds.  Would like to use natural.  What is your experience?
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Avatar_f_tn
Good luck to you!!!  I had my rt interior carotid artery dissection 6 months ago.  No attributable cause.  Headache for a week before sudden left sided paralysis. .  Very active lifestyle, wt training 2-3X week, etc. Have always had low blood pressure, no other physical problems.  I still have some weird raw/sore or stabbing sensations in my head, neck,  temple, particularly when lifting groceries or exercising too much.

There's just not that much information available because CAD is a rare event. Frustrating!!  My personal, subjective opinion is that these "spontaneous" dissections must be due to some pre-existing anomaly in the artery, a weakness in the artery that is not one of the syndromes (FMD, Horners, Marfans) that is discussed in the medical literature. Many people who get these spontaneous dissections are youngish, healthy, very physically active people.  Also, primary care doctors often have never seen this condition, ordinary people have never heard of it. It's hard to get definitive answers.  If you have had four CADs, I'd say definitely there is an underlying condition causing this, it's not a random event.  But getting a test to determine a cause is going to be hard. I'd search for answers, consult the best experts in the field. But finding them is hard!!  And sometimes they disagree.  There is an aneurysm center at Hopkins where a friend of mine who had an aneurysm (not CAD) was treated successfully.  Some place like that - multidisciplinary - like the Cleveland Clinic or Mayo Clinic might be able to help.

The only exercise I do now is walking on the treadmill.  I lift groceries, etc. but am careful.  I drive but still am careful about turning my head.  If the symptoms (twinges, stabbing pains) go away completely at some point, I'll increase activity.  After a year I'll be off Plavix.

Again, good luck!!

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Has all healing occurred?  Did you use any supplements?
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Avatar_m_tn
I've seen several people mention wearing a blood pressure monitor while exercising.  What kind do you wear?  Is it a watch (like heart rate monitor) or wrist cuff.  Thanks.
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I experienced a spontaneous left carotid artery after I had receieved unwanted pressure on my neck.That was back in 2000. After a severe headache and disorientaion for 3 days I finally went to my GP who noticed that one of my pupils was a lot more dilated than the other, She had me in hospital very quickly where the main specialist decided that I had a migraine, and with 12 students arlound my bed, explained how he knew that. They wanted to do an mri before I went home, but they put me at the end of the queue until I said I was leaving because I could manage a migraine at home. The MRI happened and a severe CAD discovered which immediately changed my medical position in the queue. I take clopidogerel, and bp tabs, and leads a fairly normal life, though often with pain. Now at 14 years on, the pain has increased a lot, I know hey cannot operate, so I deal with it as I can Every evening I take 1 or 2 mersyndol which enables me to sleep through pain, and am doing okay, but I feel I could be coming closer to my use by date going by pains I experience.
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I wanted to report and give hope to all who have experienced carotid artery dissections.  I am almost 11 months post rt interior carotid artery dissection.  Finally, I am symptom free. I had intermittent stabbing pins on the right side of my heard, face and neck until a few weeks ago.  My doctor was clueless about why I had them.  Finally, I feel like my old self.  Hope this gives hope to everyone who went through this awful experience..
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I was wondering this also, about the BCP.  I have been on them due to extremely heavy periods and have hated being on them. (I am off them as of my Dx, and may very well menstruate to anemia as I did before...) My ICAD/O was really out of the blue.  I can say I had been taking ibuprofen for two weeks prior due to some neck/shoulder pain on the opposite side.  I don't normally take stuff, am very healthy, etc.
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I'm am very happy I found this site. Sept 16 2014 I fell and twisted my body. The following week on Monday and Tuesday I had facial pain that my Dr. thought to be trigeminal pain. Wednesday, after work, I was struck with worst headache ever as I unlocked my car. In less than a minute, the painful throbbing heartbeat sensation just below my shoulders shot up the back of my neck and across the top of my head causing a temporary blackout. Coming to a few minutes later, I knew I needed help. Fortunately an ER was across the freeway from where I work. When I arrived, my BP was 219/119. After an xray and three hours of treatment they sent me home with a diagnoses of sudden-onset occipital headache. The next night the same occurred again with a slightly lower BP. This time I was diagnosed as having a migraine attack even though I told that I knew this was not one. I have had those all my life. That weekend I visited my daughter and son-in-law (a neurologist whose specialty is in strokes). He got to see a full blown attack. Arrived home Monday night. Went to work the next day but felt awful. Again Tuesday night back to the ER. This time my husband let my son-in law know that I was in trouble again. He spoke with the attending ER doctor and insisted that a CAT scan with contrast and a lumbar puncture be done. The ER Dr. saw nothing and once again sent me home with a "migraine" telling me not to work the rest of the week. The next morning as soon as a Dr. whose specialty was reading CAT scans came on duty he looked at my scans. At 8:16 that morning the attending from the night before called saying that something was found and that he was calling my regular Dr.By 8:30 he had called back saying that they were going to call to have me come in that day. I walked out of her office with a diagnosis of a carotid artery dissection and a handful of prescriptions. The next day I saw a neurologist and walked out with more prescriptions. I now take 6 meds to control BP. I experience a few stroke like symptoms but they are not consistent (trouble with right leg sometimes, visual issues, and when my head hurts there are issues with communication). It scares me to think where I might be if my son-in-law had not insisted on that CAT scan. So far, I have had 4 ER visits and should have gone 2 other times. I am so grateful to him and the doctors who are helping me to get through this.
These posts have been a true encouragement. It has also opened my eyes to the fact that I need to take this more seriously but that there is an end to the injury.
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my question is being my right side carotid artery is occulted and already had sugery on the side is it possible that you can have surgery twice on the same side please help here thank you
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UPDATE Hi Everyone I first posted here back in November 2012 because I had googled my symptoms which led me to this page.  I'm in Scotland and GP's have been useless.  I started doing my own investigations because I was told I did not have pulsatile tinnitus and that I had normal tinnitus and a headache.  No one took me serious and every doctor tried to separate my symptoms. I found a private neurologist and asked to pay for an Mra/Mrv, it was read as normal. I was still convinced something was wrong because I'm still suffering from the exact same symptoms. Two weeks ago I sent my scan to a doctor I found in New York.  He called last night to say I have a vertebral artery dissection. It happened in October 2012 while painting my ceiling.
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Thank you Craig,
I too have been diagnosed with the same thing, woke up one morning with a killer headache that wouldn't go away but I had my grandson and didn't want to scare him so I didn't go to the ED.  He went home the following day and the headache had let up a little bit but was still pulsating.  I was taking excedrin sinus in hopes that the caffeine would keep it under control, it took the edge off but that was it.  After calling in sick for 2 days, and the headaches gradually getting worse, I finally drove myself to the hospital ED, being I worked there they put me in a bed and started the test.  I had blood test, urine test, spinal tap, CT scan and a MRI.  I think it was the CT scan showed the main artery on the left side of my neck was closed off and the smaller one was about closed off, they rushed me to a nearby hospital that had a better CT scanning machine in which that one showed my artery was actually dissected.  They were determined that I had been in an accident but nothing had happened! So they told me I had a spontaneous interior carotid artery dissection on the left side of my neck.  They put me on warfarin and are in hopes it will heal itself, the headaches are still pulsating, some days worse than others, I have been out of work for a month now but am going stir crazy.  I think my Dr. is going to let me go back for half days to see how that works out.  One of my co-workers told me the other day that she would be going nuts sitting at home with "just" a headache! I wish this was "just" a headache, it would be so much easier to deal with.  Your story made me feel much better and like I wasn't being paranoid, whining or that maybe it was "just" a headache.
Thank you
Tina
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Hello fellow CAD sufferers!  I am glad to have found this support group. I had a slip and fall last Nov. 2014, and hit my head on the ground/gravel.  Had CT Scan, but negative for fractures.  Diagnosis were concussion, neck sprain and hematoma.  After few weeks, my headaches and neck pain was so severe and was radiating to my shoulders and arms causing numbness and tingling, and was referred to neurologist.  Neurologist said I had post concussion syndrome.  He requested for MRA for both brain and neck, results came back as possible carotid artery dissection by the radiologist but neuro said carotid stenosis.  Neurologist then suggest to get another MRA in six months, but I went back and saw him after a week due to chronic headaches and neck pain.  He then prescribed neurotin and baby aspirin,and requested for another MRA Intracranial.  I had VNG testing for my dizziness and results came back as labyrinthine concussion and needed vestibular therapy.  But neurologist hold off on the vestibular therapy due to risk of neck movements, saying my condition as suspected carotid artery dissection, he then change my dosage to aspirin 325 mg to prevent blood clot.  I was referred to neurosurgeon, and he said to wait for another 6 months to have another MRA, he stated dissection should heal by itself.  For the meantime, here I am wondering when this carotid artery will popped, I feel like the medications are masking my pain.  Just wondering do I really have to wait 6 months to wait and see if it heals?  Even if I have physical and massage therapy, my headaches and neck pain don't go away, I believe my headaches and neck pain is not post concussion syndrome anymore but CAD.  I used to be active and energetic, after the injury, the pain was draining my energy, it was very depressing, frustrating and disappointing. Who specializes in CAD? Is it neurosurgeon or vascular surgeon.  I was thinking of getting a second opinion, but just wondering if it's norm to wait for 6 months?
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