Seeking Advice After Recent Carotid Dissection Diagnosis
Greetings. I was recently diagnosed with a carotid dissection on the right side of my neck, following an emergency room visit two weeks ago. I'm a 50-year-old woman generally in good health, and the incident is believed to be linked to a neck adjustment performed by a chiropractor. The onset of my symptoms was quite sudden. I experienced severe headaches that gradually became more persistent and intense. Additionally, I encountered cognitive challenges such as difficulty locating words, mental fog, and forgetfulness. After enduring these symptoms for over four weeks, I consulted my primary care physician, who ordered brain x-rays—both with and without contrast—yielding normal results. After two more weeks of escalating discomfort, I decided to seek emergency care, uncertain of my next steps. A CT scan at the hospital ultimately revealed the carotid dissection. I met briefly with a neurologist who conducted a quick examination and advised me to avoid chiropractic treatments, refrain from sudden neck movements, engage in gentle exercise only, and take a daily dose of 325 mg of aspirin before sending me home. I have a follow-up appointment with a neurologist scheduled in three weeks. For reference, I reside in New York City and was treated at Weill Cornell; I understand that the doctor overseeing my follow-up at the RESCUE-TIA clinic is currently unavailable, resulting in this being the earliest appointment I could obtain. During this waiting period, I have sought to educate myself through online research, focusing on my condition. I’ve come across information regarding Transient Ischemic Attacks (TIAs) and suspect that I may have experienced one or more prior to my hospital visit. One particular day stands out; I endured a headache rated 9 out of 10 for several hours and experienced vertigo while walking. However, the ER physician did not mention TIAs to me. Regarding my diet, I have always prioritized nutritious food and continue to do so, cutting back on refined carbohydrates and eliminating added sugars. In terms of physical activity, I aim to take leisurely walks at a moderate pace three times weekly for about 45 minutes, consciously avoiding straining or holding my breath, and I only carry light loads. I prioritize rest by ensuring ample sleep and managing my stress levels carefully. To engage my mind, I’ve began doing daily puzzles and games, such as crosswords, Wordle, and Sudoku, through the Elevate app, and I've noticed a marginal improvement in my focus. I would greatly appreciate any advice on additional measures I can take or actions I should avoid. Notably, after about a week and a half following my ER visit, I experienced no headaches; however, two nights ago, I was startled by a resurgent severe headache. I thank you in advance for your assistance.
Answers (1)
8/22/2025, 7:41:45 PM
OpenHealth AI
Thank you for sharing your experience with carotid dissection. Given your recent diagnosis and the efforts you've already undertaken toward managing your health, it's understandable to feel concerned about your condition. Let’s focus on your care and empowering you during this period.
Key Points:
- Monitor Symptoms: It's crucial to keep an eye on your symptoms, especially the headaches and cognitive issues.
- Lifestyle Adjustments: Continue your gentle exercise and nutritious diet while incorporating additional preventive strategies.
- Prepare for Follow-up: Use your upcoming appointment to discuss any lingering concerns, including the possibility of TIAs.
Explanation
Carotid dissection can occur when there’s a tear in the artery wall, leading to serious complications. Your description of sudden headaches, cognitive changes, and the recent headache episodes can indeed be concerning. TIAs can sometimes be signs that additional monitoring is needed.
It's great that you are already taking steps towards a healthier lifestyle. Maintaining a balanced diet and incorporating light physical activity are beneficial. However, recognizing any changes in your health is just as important.
Next Steps
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Symptom Diary: Keep a detailed record of any headaches, cognitive issues, and other changes. Note the severity, duration, and any other triggers. This information can be invaluable for your follow-up appointment.
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Rest and Manage Stress:
- Continue prioritizing sleep and stress management techniques like deep breathing or meditation.
- If your headaches return, find a quiet, dark place to rest, as sensory overload can sometimes exacerbate pain.
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Gentle Exercise: Since you’re already walking regularly, you might consider incorporating gentle stretching, which can help with neck tension without straining the area.
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Hydration and Nutrition: Stay well-hydrated and maintain your nutritious eating habits. Foods high in Omega-3 fatty acids (like salmon and walnuts) may support vascular health.
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Avoid High-Risk Activities: Stay away from heavy lifting and vigorous physical activities that might increase strain on your neck until you get further medical advice.
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Follow-up Preparation: Prepare a list of questions or concerns for your next neurologist appointment, especially regarding your headaches and the implications of the dissection. If you suspect past TIAs, be sure to mention this.
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Consider Support Resources: Connecting with support groups for individuals with similar conditions can provide both emotional support and shared experiences, which might help during recovery.
Continue to be vigilant about your health, and know that taking these steps can empower you while you await further care. Should you notice any alarming changes—like severe headaches accompanied by vision changes, remains of vertigo, or significant cognitive alterations—reach out to healthcare services promptly. Your health is important, and self-advocacy is key during this time.
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