My Husband's Carotid Artery Dissection: A Ticking Time Bomb

Updated on December 16, 2018
ExpressionsForLif profile image

Lorena is a writer and professor. This is the story of her husband's carotid artery dissection, a life-threatening condition.

Live-Giving Blood Supply

See those beautiful red tubes running up the neck and into the brain? Those are the carotid arteries. These two large arteries bring the blood supply to the brain, and if the supply is interrupted, we may only have minutes before damage is done. One event that can disrupt this precious blood supply is a dissection, or a tear, inside the inner lining of the blood vessel.

The 3 Layers Inside Your Arteries

Layers of the artery
Layers of the artery | Source

Carotid Arteries and the Brain

Source

What Happens When Your Carotid Artery Tears?

We've probably all heard the word aneurysm, but I had never heard about dissection before this happened. We were told that our arteries have 3 layers, and the inside layer sometimes tears.

Once there is a small tear, blood sneaks through that hole and pools between the outer and middle layer. Of course, the body tries to heal itself, and so clotting begins to occur. Now you have a bulging bubble of blood and clots, and that can only lead to serious trouble. Stroke can occur when the clots let loose and move into the brain. Some people get bad headaches, and many are misdiagnosed until they actual present with the stroke. We were lucky. My husband had a rare side effect that helped us to catch the dissection before the stroke occurred.

Something Is Wrong: Follow Your Instincts

My husband woke up one Sunday morning, the last Sunday in 2013, and his eye looked puffy. We both thought it was from his sinus/upper respiratory infection. He'd started antibiotics the day before, so no big deal, right?

Thankfully, I decided to call the doctor to ask if we should be concerned, and then opened my trusty laptop. Always Google medical conditions so you can find out the full list of crazy things you might have. No, I'm kidding. But I do like to Google medical things to be sure I am informed and knowledgeable, and because I love medical stuff. Good thing.

One site said it could be from blood clots, but I didn't think it was that. It said, check the pupils in the eyes. OK. So I told my hubby to let me check. BOOM! Life changing moment. One pupil was tiny and barely responsive. It wouldn't open right. That was the eye that looked puffy. Time for a trip to the emergency room!

So, I tell my husband his pupil is wonky and we need to get to the emergency room. However, he is only 47, and he's a very strong, healthy man.

He says, "No, let's wait to see what the doctor says."

Me, "Um, NO. We are leaving now!"

I love my big strong man, and I understand his reluctance, but some things aren't up for negotiation. On the way to the hospital, my phone rang and he answered it. It was the doctor's office calling to be sure we were on our way to the emergency room.

Everyone we met after that took one look, listened to the story, and then hurried to find out what was wrong. We have a few funny stories on the way. First, the triage nurse asked a bunch of questions, in a quiet, bored manner. He finally looked up and said, you are on antibiotics, so why are you here?

"His eye," I say emphatically.

After an eye test and flashlight in his face, the nurse says, "Wait outside until we call you." He then turns, before we leave the room, and slides open a small window. He calls out to the next room, "Where is the full arrest cart? Make sure we have it ready."

My husband turns to me and tells me he doesn't like the sound of that. I tell him it isn't about him. Silly worrier. Huh. He was right. We were quickly taken to a room, seen by a doctor, and he was sent for a CT scan. Definitely not the usual slow process I've experienced in emergency rooms before. Then they moved him out of his room, into a small side area, and ten minutes later they wheeled him into a bigger room.

Hubby sees the sign saying Trauma Room and asks the nurse, "Why am I in the Trauma room?"

Nurse, "Oh, they just name the rooms. That's just the name for this one."

Right. Then the doctor comes in an stammers a bit. He stops and says, "Let me start over. You have a carotid artery dissection."

As he goes on to explain what it means, the nurses are rushing to start two IVs, one in each arm. One nurse says, "Sorry, we have to put a big needle on this side in case we need to get meds in you fast. This will hurt."

Once the heparin (blood thinner) is started, they rush Roger up to ICU. They are talking about surgery, and sending him to a bigger hospital an hour away. It takes less than an hour to hear from the Vascular Surgeon. His dissection is too dangerous to consider operating on at this time. We get to stay in our hometown, and hope the doctors can fix this with medicine.

He is checked constantly in ICU, and the next morning we begin to see doctors. He ends up with four on the case. His General doctor, the vascular surgeon, a neurologist, and a cardiologist. They are all amazed and intrigued by his case. He is one in a million. The doctor in charge of the E.R. for the night comes to tell us he's never seen a case like Roger's, and he probably never will again. Roger has a rare condition called Horner's Syndrome, and it probably saved him from a stroke, or worse.

Horner's is the name of the syndrome that comes when the nerves to the eye are damaged and the pupil stops responding, the eye droops, and there is intense pain and pressure. If we hadn't noticed that, he would have gone on to the next step, and probably had a stroke. Horner's can be caused by a few different things,and one is when the carotid artery dissects, and then the bulge pushes on the nerves to the face. He is now in pain from that, but his brain is intact.

Contributing Factors

Why does the dissection happen? That is a good question, and one that hasn't been completely answered. There are two different kinds. One is from trauma, like in a car accident, and the other is called spontaneous dissection. My husband's was the second one, though they think a rather violent sneeze caused the tear. My kids are now afraid to sneeze, but there were other factors involved.

First, the condition of the artery is considered. As we age, and depending on our lifestyle, our arteries can become less elastic. Smoking, high cholesterol, and high blood pressure all take a toll on our vascular system. My husband had smoked for over 10 years, and his blood pressure had recently been crawling higher and higher. It was only a few months, and the doctors were at a point where, if his pressure didn't go down, they were going to prescribe medicine for that.

For some unknown reason, a good percentage of people who have had a carotid artery dissection, or CAD, have had an upper respiratory infection just previous to the event. My husband was quite sick with a bad cough and was on antibiotics and over-the-counter cold medicine. This may have raised his blood pressure even more. If there is a tear, and the blood is forcefully pushing through the artery, the lining will rip even farther. His tear starts low on his neck and goes all the way up into his skull.

Our neurologist said to picture a rug, and when a piece rips and is then pushed by a flood of water, it can roll right up as it goes. Or picture a fruit roll up. Either way, the flap of tissue that tore rolled up and blocked (occluded) his artery 90%. They aren't sure if that will get better as it heals. It may stay blocked, or it may open up some. Only time will tell.

So now, he is not supposed to stress, lift his arms up over his shoulders, lift more than 10 lbs, stretch, twist, cough, sneeze, or strain. You get the idea. Plus he is in pain from the nerve damage and possibly the healing process. It is a long recovery, and chances are good that he will never go back to his construction job. He'd worked his way up to a well respected position, and a decent career. Now we have no income, and his life has changed...but don't stress.

This will be a learning experience from here on out. Learning how to start over in middle age. Learning how to lower stress in our lives. Learning to appreciate family and the good friends that have been there to help us through this. Learning to take better care of ourselves. The wonderful part is that we still have Roger with us. The rest we can deal with. One thing that has helped is finding a group on Facebook of other CAD survivors. If there are more of you out there, please comment so we can get in touch. You know how important that can be as he is healing.

Enjoy each day, and don't let the little things ruin the good in life. We are thankful for each day we have together to continue learning and loving.

Eating Healthy Is Now a Priority

Eating to promote a healthy heart has become a new way of life in our family. We used to alternate between eating healthy and then opting for faster, cheaper alternatives when things got busy. We no longer have that luxury.

Since Roger must keep his blood pressure low, a low-salt diet is essential. That means no processed food. In addition, we are upping the fresh fruit containing vitamin C for healthy blood vessels. We have also reduced the amount of red meat and fat in our diets.

We have discovered some great new recipes, and I will work to share them on another article soon. Take care, and hug your loved ones today.

Dissection or Horner's Syndrome

Do you know anyone With a Dissection of an Artery, or Horner's Syndrome?

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This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

Questions & Answers

  • Has your husband had any more dissections or just the one? I’m on my third and feel so alone and scared.

    He only had the one, but we know of others that have had multiple dissections. My husband is very careful, and as you can probably relate, overly cautious to the point of being scared to do much at all. He has shoveled a couple of times but usually ends up with terrible headaches for days and days. He changed his eating and other habits too. You aren't alone. Have you tried to connect on FaceBook? There is a great group there called Carotid Artery Dissection, and you can also ask to join their private group, Carotid Artery Dissection Support.

Comments

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  • profile image

    Ralph Jennings 

    4 weeks ago

    Great - thanks Lorena. Im now connected to all the info on that FB group.

  • ExpressionsForLif profile imageAUTHOR

    Lorena Wood 

    4 weeks ago

    Ralph. Your story sounds like ours. Glad you are still here and still you. My hubby still struggles with the head pain. He has more good days, and knows what triggers the bad days more often. He can do a bit more than when it first happened, but it still gets triggered by exertion and possibly stress and sickness. We have found that eating better and avoiding junk and sugar can help some, but that isn't a cure.

    Good luck and keep in touch! Everyone heals differently from this. There is a FaceBook group we love if you want to talk to more that have been through this.

    https://www.facebook.com/groups/47265659349/

  • profile image

    Ralph Jennings 

    4 weeks ago

    Hi - I’ve only just read this article and all the subsequent comments. It’s been comforting for me to read about others who have experienced a dissected carotid artery - which helps with my current stress levels.

    Just a month ago (Dec 30th, 2019) I was diagnosed with a dissected internal carotid artery on the right side of my neck. I’m interested to seeing how people who have joined this discussion are doing now – years after their dissection diagnosis.

    I’m 52, and I’ve always been a very active healthy person. I’ve been an avid competitive runner for 30+ years, and just earlier in 2019 I ran a 125K mountain run in Spain (over 8000 metres climbed). I’ve also run 6 other ultra-marathons over 100K in the last few years, and I’ve completed an Ironman as well. I have had blood pressure monitored and blood tests taken regularly over the last 10-15 years, and I’ve never had an issue with high blood pressure, but over the last year or so my cholesterol has been just slightly high - although the ratio of good/bad has always been good. On Dec 11th, I went for a 10k training run in very cold, windy conditions. Mid-way through it hailed on me and I tried to seek cover – but got pelted with smallish hailstones. When I finished the run, I was so tense, that I felt I needed to crick my neck to feel a release of tension (DO NOT DO THIS AT HOME!!! I’ve known this, but just didn’t think at the time). Right after the self-manipulation of my neck (just lightly twisting it), I got a severe headache. But I didn’t worry as I just thought it was from the cold weather. I started taking some painkillers (which masked the pain), and the headache came and went for the next 2 weeks. Still (stupidly), I just thought it was a combination of the winter weather and dehydration. On Dec 27th, I went for another run – this time it was 15 miles. After running 10 miles, I felt a sharp pain behind my right eye, and this was followed by my sunglasses completely fogging up (or so I thought)…. I took the glasses off and realised it was actually my eyeball. Everything got blurry in the right eye and I started to feel light-headed and disoriented. I stopped and just stood there for 10 minutes trying to come to my senses. Then the blurriness in my right eye subsided, and I started to feel a bit more normal – so I continued to jog the remaining 5 miles back home with no issues. But I did have a headache after this run as well. The next day I ran a 5k race fairly quickly and did not have any issues until later in the evening when the headache became quite severe again and I realised it was all on the right side of my head (as I hadn’t really realised that before – so this was my “red flag” worry moment – even though there were so many flags before this). I went to the doctor the next morning, and the first thing she noticed was my right eye drooping and the pupil significantly smaller than the left eye. She immediately suspected Horner’s syndrome, and sent me to A&E right away to get the CT angiography. After the scan, they detected the internal carotid artery tear and gave me the news. The way they gave me the news somewhat surprised me – basically saying we are so sorry to give you some bad news - you’ve got a large dissection in your internal carotid artery – we know it’s tough to hear this as you are in good fitness. I was actually relieved to at least have a diagnosis so I knew the reason for the headaches and other issues – but the way they told me kind of stressed me out (like it was a terminal thing), so my blood pressure went sky high (180/110). After trying to figure out how the dissection could have happened and the nature of my dissection, I was told that I have definitely must have suffered a TIA or stroke at some point in my past as well as when I had the episode during my 15 mile run a few days earlier. They said the dissection probably occurred when I got the headache after the 10k run a few weeks earlier (he said neck manipulation rarely causes a dissection, so they weren’t convinced this caused the tear). The stroke consultant said I was extremely lucky that I did not suffer a massive stroke from the intense exercise I was doing after already having a dissection – he said luckily my overall cardiovascular system was strong enough to make up for the blockage on the right side to my brain. It is ironic that the exercise level saved me as well as could have killed me…. But they said absolutely NO EXERCISE until the tear is healed. So, we still do not know what really caused the dissection. I’m adopted, so I’m still trying to get more info on my biological family medical history.

    I’m now on the Clopidogrel (blood thinner) and a statin to reduce my cholesterol (although I want to get off this right away and rely on a revised diet of cutting out processed foods and drinking alcohol which I’ve now done successfully for a month). My blood pressure has been completely normal for nearly a month as well. get a follow-up CT scan in 2 weeks to see how the healing is going, so I’m keeping my fingers and toes crossed – I know it’s still very early days and it takes ages for this to heal, if ever. My headaches have subsided, but I do get the severe headaches when I get a little stressed or if I go outside in the cold weather (even for a very gentle walk).

    I’d love to know how people here have recovered and if they have been able to get to a point of being more active. Health ALWAYS comes first (especially when it’s a serious thing that affects the blood flow and oxygen to the brain!), but I’d love to be able to be somewhat active again – it’s always defined me as a person. Feel free to message back on Facebook to me and let me know how you have progressed in recovery. https://www.facebook.com/ralph.jennings1

    Thanks!

    Ralph

  • profile image

    Peterelee 

    21 months ago

    Hi I have horners syndrome from a CAD in 2015 at the age of 54 .I visited the hospital twice, the first time I was sent home with possible Bell's palsy! My local doctor was no better but a week later I was rushed into A&E with a possible stroke! My only saving grace is I have always taken aspirin as a pain killer and as my eye pain was so bad I took two aspirin before arriving at A&E .They looked at my pupils ,did a chest X-ray and put me on blood thinners straight away. They then gave me an MRI brain and neck scan which revealed a left side internal Caratoid artery dissection.The cause l believe was a blow on the front of my head when I hit a wood beam a week before.After three to four months I had another MRI scan and the artery had made a full recovery.l am on thinners and statins indefinitely and still have Horners with daily pain caused by the nerve damage.The pain is hard to describe sometimes like spiders crawling on my face , heat on my face, eye pain all on my left side with a hoarseness in my throat it all comes together.l have painkillers which masks the pain.I am reluctant to take these on a daily basis but alternative pain relief such as acupuncture which I tried didn't really help. I would appreciate any other suggestions.

  • profile image

    valeriehall713 

    2 years ago

    Hi Everyone,

    I woke up in October of 2016 with Horner's Syndrome from a spontaneous dissection (right) and was treated at two (2) different hospitals in Phoenix. They both said I had Bell's Palsy and sent me home. It wasn't until I went to my eye doctor that I was sent to the proper facility where an MRA was performed and the dissection was found. My dissection is considered chronic and was wondering if anyone else had that diagnosis. Thank you and be well!

  • ExpressionsForLif profile imageAUTHOR

    Lorena Wood 

    3 years ago

    Sandra RN. I'm sorry you are in our new club. It is interesting to hear this from a RN point of view. I wish doctors knew more. They don't understand the pain, or at least we haven't met any that do yet. My husband is now 3 years out and still has the right sided face and head pain. He is still learning to live with it, with some pain medications and limitations. It's been a long three years.

  • profile image

    Sandra RN 

    3 years ago

    I also suffered an internal carotid artery dissection about 6 months ago. I was treated at Cedars Sinai in LA and my experience was quite different. I also presented with Horner's Syndrome. I had been experiencing what I thought was eye fatigue as I was working a lot(I'm an RN). When I realized my pupil was sluggish to respond to light I went to the ER immediately thank God!!

    I was seen right away and CT angio was done probably within 2 hours of being in the ER. After diagnosis I was heparinized to break up any clots that could cause stroke. I was kept for about 3 days on a non monitored neuro/stroke floor. I had an MRI to rule out any strokes I had a transcranial Doppler to detect any clots that might have already been formed. My dissection was deemed to be stable and I was sent home on aspirin 325mg daily.

    The pain didn't really set in for about 10 days. I am a migraine sufferer which complicates my treatment. The pain is referred to as a neuralgia and affects mostly the left side of my face specifically my left temple. I am unable to take my Imitrex for migraines as it may further impair blood flow to the brain. It's been a long haul fighting with my HMO to get necessary pain management treatments.

    I had a total of 6 weeks off work before returning to my duties as an RN

    It looks like there has been little healing as seen on my follow up CT and MRI.

    Would love to hear about others healing process and treatment course. Anybody had cerebral angiograms or stents??

  • profile image

    Hstevens07 

    4 years ago

    I am so glad I found this article, and feel as though I'm somewhat reading my story!

    Only difference being that I am a 32 year old women that has been fairly healthy without high blood pressure or cholesterol up until immediately before it happened. That, and I was sent home from the ER three different times before they found what it was. I had the severe headache, and extreme pain right above my left eye, and in the back of my head going down my neck along with shoulder pain going down my left arm. I also had extremely high blood pressure (180's) and a very high d-dimer level which usually indicates clotting somewhere in the body. They found that out on my first Er visit (two weeks prior to finding the dissection) and then sent me home saying I would be fine after they found no clots in my lungs or brain. I had been diagnosed with strep throat right before I was diagnosed with the dissection, which actually turned out to be a huge blessing from God because that is the only reason they did a ct angio scan of my neck thinking I possibly had mastitis of the bone based on where the pain was located in the back of my head and neck and can be a complication of strep. I found out later that the doctor who ordered that CT scan saved my life, because had he not I would have had a stroke, and based on where the tear is located, odds are that if I had survived it, I would have been a vegetable.

    The other difference is that unfortunately my dissection has gotten worse in theast two weeks instead of improving, and there are two tears, one at the C1 vertebrae and one just prior to the dura (this is the one that is extremely dangerous right now because it has doubled in size) This unfortunately means that not only am I still at risk for stroking, but we also still don't really know where we go from here.

  • profile image

    Hstevens07 

    4 years ago

    I am so glad I found this article, and feel as though I'm somewhat reading my story!

    Only difference being that I am a 32 year old women that has been fairly healthy without high blood pressure or cholesterol up until immediately before it happened. That, and I was sent home from the ER three different times before they found what it was. I had the severe headache, and extreme pain right above my left eye, and in the back of my head going down my neck along with shoulder pain going down my left arm. I also had extremely high blood pressure (180's) and a very high d-dimer level which usually indicates clotting somewhere in the body. They found that out on my first Er visit (two weeks prior to finding the dissection) and then sent me home saying I would be fine after they found no clots in my lungs or brain. I had been diagnosed with strep throat right before I was diagnosed with the dissection, which actually turned out to be a huge blessing from God because that is the only reason they did a ct angio scan of my neck thinking I possibly had mastitis of the bone based on where the pain was located in the back of my head and neck and can be a complication of strep. I found out later that the doctor who ordered that CT scan saved my life, because had he not I would have had a stroke, and based on where the tear is located, odds are that if I had survived it, I would have been a vegetable.

    The other difference is that unfortunately my dissection has gotten worse in theast two weeks instead of improving, and there are two tears, one at the C1 vertebrae and one just prior to the dura (this is the one that is extremely dangerous right now because it has doubled in size) This unfortunately means that not only am I still at risk for stroking, but we also still don't really know where we go from here.

  • profile image

    Alfalfablue 

    4 years ago

    Hey, I thought I should maybe add another perspective on this page. I'm late 30s, M, suffered an internal carotid artery dissection almost a year ago that led to a transient ischemic attack (TIA) including loss of vision and Horner's syndrome in my right eye. Imaging showed a 4in tear from my throat to my eye.

    It was terrifying. So terrifying that I had panic attacks that led to difficulty breathing, tightness at the base of my skull/neck that made it hard to turn my head, light headedness and breathlessness whenever I even thought about the injury, etc. It still happens occasionally, but I pretty much overcame the attacks with (4 hours of) therapy, mindfulness, and breathing control.

    The good news: I've been on anticoagulants since the dissection, but I anticipate going off them at 12 months. My Horner's cleared up within a couple of weeks. Since the injury (I still don't know how it happened!) I have taken up a much more active lifestyle than I had previously, including running 3 times a week, strength training, etc, with my doctor's blessing. I'm healthier than I've ever been. So if you've just been diagnosed with a cervical dissection, don't despair! There is every chance you'll be OK.

  • ExpressionsForLif profile imageAUTHOR

    Lorena Wood 

    4 years ago

    Kimberlee,

    I just followed you on Twitter so I can read your story, and stay connected. I'm @LorenaWood15.

    The facebook page is https://www.facebook.com/groups/47265659349

    One thing I should warn you about. It's great when you are new and need support, but some stories are scary. Not everyone recovers as well as you and my hubby. Some may have other issues, or may not take their meds or follow doctors. You positive story will encourage others there. So glad you are healing well and have a second chance on life!!

  • KimberleeKDodd profile image

    KimberleeKDodd 

    5 years ago

    What is the mentioned Facebook page for Carotid Artery Dissection survivors?

    My story is tweeted @KimberleeKDodd on 10-28-14.

  • KimberleeKDodd profile image

    KimberleeKDodd 

    5 years ago

    I had a Carotid Artery Dissection May 2014. The stories above sound very similar to mine. 80-90% blockage. Right-brain stroke. Speech impaired, slowly came back. Leaking vessel in right eye healed. Left shoulder still bothers me. I was treated with Plavix, 325mg aspirin, Lipitor, Protonix, and blood pressure medicine. 6 mth scan in December revealed complete healing and complete clearing!

  • ExpressionsForLif profile imageAUTHOR

    Lorena Wood 

    5 years ago

    MBDamorano So sorry to hear about your serious health issues at such a young age. Wow. My husband is healing, but not 100% yet. At 6 months he thought he would be stuck with all the pain and issues, but now, at 10 months I can tell you he is still improving. His horners is much better, though it still acts up when tired and all that. The pain has decreased, and he recovers much faster when he does overdo things. The one thing he did that I encourage....is to...REST in the beginning!!!! REST and HEAL. Take your meds and let your body heal. Bodies can heal even a year after an event. Good luck!!

  • profile image

    mbdamoreno 

    5 years ago

    I am 23 years old. I had my dissection last year at 22. I'm a healthy female with no history of health problems. I too had horners syndrome and still have it to this day. My right eye droops if I'm to hot, stressed, tired or upset and especially with headache. I'm on blood thinners for the rest of my life and still have a slight tear and see a neurologist every 3 months. My once perfect vision is now almost gone in my right eye and i have thousands in medical debt. I'm so glad I'm not the only one out there with this. The hospital i went too also was perplexed as to why this happened, i did have a sinus infection around the same time as well. I hope your husband is well. It really is a struggle to be so limited on what you can do.

  • ExpressionsForLif profile imageAUTHOR

    Lorena Wood 

    5 years ago

    I added you on Twitter. @LorenaWood15 Take it easy and let things heal. My hubby's blood clot has resolved and blood flow is better. Still can't risk tearing more. Imaging in June will be 6 month mark. Hoping for good news.

  • profile image

    Patrick Konen 

    5 years ago

    I could not believe what i was reading, because I have a dissecting interior carotid artery that is completely blocked with a 2 in. blood clot. The surgeons are afraid to touch it and am on blood thinners. They did an MRI and confirmed I have a tear inside the artery. Am 50 years old and can't return to work as a correctional officer. Please twitter me at@kids2355

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